Prevalence and risk factors of atrial fibrillation in type 2 diabetes mellitus: a hospital-based cross-sectional study

Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with adverse cardiovascular outcomes. In type 2 diabetes mellitus (T2DM), AF further increases the risk of heart failure, stroke, and premature death. However, epidemiological data in Asian populations remain limited. This study aimed to clarify the prevalence and identify risk factors of AF among patients with T2DM. We conducted a hospital-based cross-sectional study using retrospectively collected medical records. AF was identified from physician documentation with electrocardiographic confirmation, including paroxysmal, persistent, and permanent types. Demographic, clinical, and laboratory variables were compared between AF and non-AF groups, and independent risk factors were assessed using multiple logistic regression. Among 427 T2DM patients (mean age 63.6 ± 11.6 years), AF prevalence was 10.5%. Independent predictors of AF were older age (OR 1.06, 95% CI 1.02–1.11; p = 0.001), higher BMI (OR 1.07, 95% CI 1.01–1.13; p = 0.040), and heart failure (OR 4.39, 95% CI 1.56–12.39; p = 0.005). The predictive model incorporating these factors demonstrated fair discriminative ability (AUC 0.75, 95% CI 0.68–0.83). AF was present in one in ten T2DM patients. Older age, elevated BMI, and heart failure were independent predictors, and together provided moderate accuracy for AF risk prediction. These findings support targeted cardiovascular risk assessment and opportunistic AF screening in high-risk patients.