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No evidence of a causal association of type 2 diabetes and glucose metabolism with atrial fibrillation – published online 27/02/2019

No evidence of a causal association of type 2 diabetes and glucose metabolism with atrial fibrillation – published online 27/02/2019

Hadi Harati, Daniela Zanetti, Abhiram Rao, Stefan Gustafsson, Marco Perez, Erik Ingelsson, Joshua W. Knowles

Type 2 diabetes and less marked forms of dysglycaemia have been associated with increased risk of incident atrial fibrillation in epidemiological studies. However, it is unclear whether this association is causal. In this issue, Harati et al (https://doi.org/10.1007/s00125-019-4836-y) used Mendelian randomisation to answer this question. Using publicly available summary statistics data from genome-wide association studies, the authors did not find a causal role between genetically programmed type 2 diabetes, fasting blood glucose or HbA1c and the development of atrial fibrillation. These data suggest that drug treatment to reduce dysglycaemia is unlikely to be an effective approach for the prevention of atrial fibrillation. The authors conclude that, in line with the previously reported causal link between BMI and atrial fibrillation, these results suggest that strategies that aim to control type 2 diabetes-related comorbidities (such as obesity) are likely to be more effective in preventing atrial fibrillation than those that aim to control blood glucose.

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