Arrhythmias & electrophysiology
Circulating ketone bodies, genetic susceptibility, with left atrial remodeling and atrial fibrillation: A prospective study from the UK Biobank
Authors' conclusion
There was a U-shaped association of circulating total KBs and β-OHB with incident AF as well as a positive association of acetoacetate and acetone levels with AF risk in the general population.
Study context
- Population
- UK Biobank participants free of atrial fibrillation (AF) at baseline with data on circulating ketone bodiesmean age 56.5 years
- Participants
- 237,163 participants
- Exposure
- Circulating ketone body levels and incident AF
- Outcome
- Incident AF
- Follow-up
- Median 14.8 (13.8, 15.5) years
Methodological detailsUK Biobank
- UK Biobank
Main finding
As reported in the abstract
Incident AF
16,638
7.0%
U-shaped association of total ketone bodies (KBs) with incident AF, nadir 60.6 μmol/L
Pnonlinear < .05
U-shaped association of β-OHB with incident AF, nadir 40.8 μmol/L
Pnonlinear < .05
Positive association of acetoacetate and acetone with AF
Poverall < .001; Pnonlinear > .05
Observational data: associations, not effects.
Further findings
Left atrial (LA) volume parameters (LA maximum and minimum volume, BSA-indexed)
- U-shaped association of total KBs and β-OHB with LA volume parameters
- Pnonlinear < .05
LA ejection fraction
- Inverted U-shaped association of total KBs and β-OHB with LA ejection fraction
- Pnonlinear < .05
AF by polygenic risk score of AF (low, moderate, high) (subgroup)
- Associations of KBs with AF stronger in low genetic risk
- P for interaction < 0.05
- Highest AF risk in high genetic risk with high KB levels
- Interaction P < .05
Mediation by inflammatory markers
- Significant mediation effects of inflammatory markers on associations between KBs and AF
Original publication
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