Objective To investigate the relationships of serum levels of B-type natriuretic peptide (BNP) and insulin-like growth factor binding protein-3 (IGFBP-3) with the occurrence of atrial fibrillation in patients with non-alcoholic fatty liver disease (NAFLD).

Methods A total of 105 patients with NAFLD were included in observation group, and another 105 healthy individuals were included in control group. Clinical data of the patients were collected, and serum levels of BNP and IGFBP-3 were compared between the two groups. The influencing factors of atrial fibrillation in patients with NAFLD were analyzed, and the interactive effects of serum BNP and IGFBP-3 on the risk of atrial fibrillation in patients with NAFLD were explored. The predictive value of serum BNP and IGFBP-3 levels for atrial fibrillation in patients with NAFLD was also evaluated.

Results The serum levels of BNP and IGFBP-3 in the observation group were significantly higher than those in the control group (P<0.05). Among the patients in the observation group, 30 cases developed atrial fibrillation within one year. The levels of body mass index (BMI), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), BNP, and IGFBP-3 were higher in patients with atrial fibrillation compared to those without, while the level of high-density lipoprotein cholesterol (HDL-C) was lower (P<0.05). BMI, TC, TG, HDL-C, LDL-C, BNP, and IGFBP-3 were all influencing factors for the occurrence of atrial fibrillation in patients with NAFLD (P<0.05). There was an interaction between BNP and IGFBP-3, 50.47%of the risk of atrial fibrillation in patients with NAFLD was attributed to this interaction. The area under the curve for the combined prediction of serum BNP and IGFBP-3 was 0.928, which was significantly larger than the AUC of 0.753 and 0.821 for the individual predictions of BNP and IGFBP-3, respectively (P<0.05).

Conclusion The expression levels of BNP and IGFBP-3 in the serum of patients with NAFLD are significantly elevated, and the combined use of these markers can effectively predict the occurrence of atrial fibrillation in these patients.