Non-alcoholic fatty liver disease is associated with an increased prevalence of atrial fibrillation in hospitalized patients with type 2 diabetes.

NAFLD (non-alcoholic fatty liver disease) and AF (atrial fibrillation) are two pathological conditions that are highlyprevalent in developed countries and share multiple risk factors. The relationship between NAFLD and AF in Type 2diabetes is currently unknown. We studied a hospital-based sample of 702 patients with Type 2 diabetesdischarged from our Division of Endocrinology during 2007–2011. The diagnosis of AF was confirmed in affectedparticipants on the basis of ECGs and medical history by experienced cardiologists. NAFLD was defined byultrasonographic detection of hepatic steatosis in the absence of other liver diseases. Of the 702 hospitalizedpatients included in the study, 514 (73.2%) of them had NAFLD and 85 (12.1%) had persistent or permanent AF.NAFLD was associated with an increased risk of prevalent AF {OR (odds ratio), 3.04 [95% CI (confidence interval),1.54–6.02]; P<0.001}. Adjustments for age, sex, systolic BP (blood pressure), HbA1c, (glycated haemoglobin),estimated GFR (glomerular filtration rate), total cholesterol, electrocardiographic LVH (left ventricular hypertrophy),COPD (chronic obstructive pulmonary disease), and prior history of HF (heart failure), VHD (valvular heart disease)or hyperthyroidism did not attenuate the association between NAFLD and AF [adjusted OR, 5.88 (95% CI,2.72–12.7); P<0.001]. In conclusion, our results show that ultrasound-diagnosed NAFLD is strongly associatedwith an increased prevalence of persistent or permanent AF in patients with Type 2 diabetes, independently ofseveral clinical risk factors for AF. The potential impact of NAFLD on AF deserves particular attention, especially withrespect to the implications for screening and surveillance strategies in the growing number of patients with NAFLD.