Case-control Study On The Serum Lipids Spectrum In Patients With And Without Atrial Fibrillation

Objective To investigte the potential association between serumlipids spectrum and atrial fibrillation (AF).Method598patients with AF （including295paroxysmal AF, PAFand303non-paroxysmal AF, NPAF）were enrolled and596patientswithout AF and matched in hypertension and diabetes as control in the study.Primary clinical and laboratory datum which were consist of white blood cellcount (WBC) and neutrophilic granulocyte ratio, liver function， fastinglipids and blood glucose, renal function, thyroid function，ECG and/orHolter-ECG and Echocardiograph were collected in all patients. To observedand lipid analysis blood lipid levels changes in the atrial fibrillation groupand sub-group with the control group.Statistical analysis was performed bySPSS19.0software.Results Compared to the control, there were significant decreased inthe parameters of triglyceride(TG), total cholesterol (TC), high densitylipoprotein (HDL), low density lipoprotein (LDL), apoA1,apoB and leftventricular ejection fraction （EF）and significant increase in age, WBCcount, neutrophilic granulocyte ratio and left atrium diameter (LAD) inpatients with atrial fibrillation group. The multivariate stepwise Logistcregression analysis showed that WBC and LAD were positive correlationwith atrial fibrillation（OR=1.119,95%CI1.012-1.237, P=0.024and OR=1.147,95%CI1.116-1.178, P=0.000, respectively），while TG, HDLand LDL were negative correlation with atrial fibrillation （OR=0.822,95%CI0.704-0.961, P=0.014; OR=0.401,95%CI0.247-0.651, P=0.000andOR=0.736,95%CI0.595-0.911, P=0.005; respectively）. Further subgroupregression analysis showed that HDL （OR=0.420,95%CI0.216-0.815,P=0.010）, LDL （OR=0.695,95%CI0.515-0.936, P=0.017） werenegative and LAD （OR=1.0785,95%CI1.039-1.118, P=0.000） positivecorrelation but TG statistical non-correlation with PAF. Notably, there werenegative correlation between HDL, LDL and TG as well （OR=0.219,95%CI0.106-0.451, P=0.000; OR=0.638,95%CI0.455-0.895, P=0.009andOR=0.676,95%CI0.523-0.873, P=0.003; respectively） with NPAF,meanwhile LAD（OR=1.247,95%CI1.197-1.300, P=0.000） was positivecorrelation with NAPF.Conclusion Blood lipids especially LDL and HDL levels weresignificantly lower in patients with atrial fibrillation, and prone to decreasedgradually with the progress of paroxysmal atrial fibrillation into chronicatrial fibrillation. The mechanism involved in this “Cholesterol Paradox” inatrial fibrillation need to be clarified.