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Severity and multiplicity of microvascular complications are associated with QT interval prolongation in patients with type 2 diabetes

Kobayashi, Shunsuke; Nagao, Mototsugu LU ; Asai, Akira; Fukuda, Izumi; Oikawa, Shinichi and Sugihara, Hitoshi (2017) In Journal of Diabetes Investigation
Abstract

AIMS/INTRODUCTION: A prolonged QT interval plays a causal role in life-threatening arrhythmia and becomes a risk factor for sudden cardiac death. Here, we assessed the association between microvascular complications and the QT interval in patients with type 2 diabetes.

MATERIALS AND METHODS: Patients with type 2 diabetes (n = 219) admitted to our hospital for glycemic control were enrolled. QT interval was measured manually in lead II on the electrocardiogram and corrected for heart rate using Bazett's formula (QTc). Diabetic neuropathy, retinopathy, and nephropathy were assessed by neuropathic symptoms or Achilles tendon reflex, ophthalmoscopy, and urinary albumin excretion, respectively.

RESULTS: In univariate analyses,... (More)

AIMS/INTRODUCTION: A prolonged QT interval plays a causal role in life-threatening arrhythmia and becomes a risk factor for sudden cardiac death. Here, we assessed the association between microvascular complications and the QT interval in patients with type 2 diabetes.

MATERIALS AND METHODS: Patients with type 2 diabetes (n = 219) admitted to our hospital for glycemic control were enrolled. QT interval was measured manually in lead II on the electrocardiogram and corrected for heart rate using Bazett's formula (QTc). Diabetic neuropathy, retinopathy, and nephropathy were assessed by neuropathic symptoms or Achilles tendon reflex, ophthalmoscopy, and urinary albumin excretion, respectively.

RESULTS: In univariate analyses, female gender (P = 0.025), duration of type 2 diabetes (P = 0.041), BMI (P = 0.0008), systolic blood pressure (P = 0.0011), and receiving insulin therapy (P < 0.0001) were positively associated with QTc. Patients with each of the three microvascular complications had longer QTc than those without; neuropathy (P = 0.0005), retinopathy (P = 0.0019), and nephropathy (P = 0.0001). As retinopathy or nephropathy progressed, QTc became longer (P < 0.001 and P < 0.001 for trend in retinopathy and nephropathy, respectively). Furthermore, QTc was prolonged with the multiplicity of the microvascular complications (P < 0.001 for trend). Multiple regression analyses revealed that neuropathy, nephropathy, and the multiplicity of the microvascular complications were independently associated with QTc.

CONCLUSIONS: Patients with type 2 diabetes with severe microvascular complications may be at high risk for life-threatening arrhythmia associated with QT interval prolongation. This article is protected by copyright. All rights reserved.

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author
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publication status
epub
in
Journal of Diabetes Investigation
publisher
Wiley-Blackwell
external identifiers
  • scopus:85038034473
ISSN
2040-1116
DOI
10.1111/jdi.12772
language
English
LU publication?
no
id
d95e910a-8d9b-429a-9e94-2ec1c0a8a9ac
date added to LUP
2017-11-19 11:16:36
date last changed
2018-03-04 05:07:12
@article{d95e910a-8d9b-429a-9e94-2ec1c0a8a9ac,
  abstract     = {<p>AIMS/INTRODUCTION: A prolonged QT interval plays a causal role in life-threatening arrhythmia and becomes a risk factor for sudden cardiac death. Here, we assessed the association between microvascular complications and the QT interval in patients with type 2 diabetes.</p><p>MATERIALS AND METHODS: Patients with type 2 diabetes (n = 219) admitted to our hospital for glycemic control were enrolled. QT interval was measured manually in lead II on the electrocardiogram and corrected for heart rate using Bazett's formula (QTc). Diabetic neuropathy, retinopathy, and nephropathy were assessed by neuropathic symptoms or Achilles tendon reflex, ophthalmoscopy, and urinary albumin excretion, respectively.</p><p>RESULTS: In univariate analyses, female gender (P = 0.025), duration of type 2 diabetes (P = 0.041), BMI (P = 0.0008), systolic blood pressure (P = 0.0011), and receiving insulin therapy (P &lt; 0.0001) were positively associated with QTc. Patients with each of the three microvascular complications had longer QTc than those without; neuropathy (P = 0.0005), retinopathy (P = 0.0019), and nephropathy (P = 0.0001). As retinopathy or nephropathy progressed, QTc became longer (P &lt; 0.001 and P &lt; 0.001 for trend in retinopathy and nephropathy, respectively). Furthermore, QTc was prolonged with the multiplicity of the microvascular complications (P &lt; 0.001 for trend). Multiple regression analyses revealed that neuropathy, nephropathy, and the multiplicity of the microvascular complications were independently associated with QTc.</p><p>CONCLUSIONS: Patients with type 2 diabetes with severe microvascular complications may be at high risk for life-threatening arrhythmia associated with QT interval prolongation. This article is protected by copyright. All rights reserved.</p>},
  author       = {Kobayashi, Shunsuke and Nagao, Mototsugu and Asai, Akira and Fukuda, Izumi and Oikawa, Shinichi and Sugihara, Hitoshi},
  issn         = {2040-1116},
  language     = {eng},
  month        = {11},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Diabetes Investigation},
  title        = {Severity and multiplicity of microvascular complications are associated with QT interval prolongation in patients with type 2 diabetes},
  url          = {http://dx.doi.org/10.1111/jdi.12772},
  year         = {2017},
}