Severity and multiplicity of microvascular complications are associated with QT interval prolongation in patients with type 2 diabetes |
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| Authors: | Shunsuke Kobayashi Mototsugu Nagao Akira Asai Izumi Fukuda Shinichi Oikawa Hitoshi Sugihara |
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| Affiliation: | 1. Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan;2. Food and Health Science Research Unit, Graduate School of Agricultural Science, Tohoku University, Sendai, Japan;3. Diabetes and Lifestyle‐related Disease Center, Japan Anti‐Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan |
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| 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 Nippon Medical School Hospital (Tokyo, Japan) 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 sex (P = 0.025), duration of type 2 diabetes (P = 0.041), body mass index (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 showed 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 might be at high risk for life‐threatening arrhythmia associated with QT interval prolongation. |
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| Keywords: | Microvascular complications QT interval Type 2 diabetes mellitus |
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