Ninkovic Vladan M, Ninkovic Srdjan M, Miloradovic Vanja, Stanojevic Dejan, Babic Marijana, Giga Vojislav, Dobric Milan, Trenell Michael I, Lalic Nebojsa, Seferovic Petar M, Jakovljevic Djordje G
Department of Cardiology, Specialist Hospital Merkur, Bulevar Srpskih Ratnika 18, 36210, Vrnjacka Banja, Serbia.
Clinical Centre, Kragujevac, Serbia.
Acta Diabetol. 2016 Oct;53(5):737-44. doi: 10.1007/s00592-016-0864-y. Epub 2016 Apr 23.
Prolonged QT interval is associated with cardiac arrhythmias and sudden death. The present study determined the prevalence of prolonged QT interval and QT dispersion and defined their clinical and metabolic predictors in patients with type 2 diabetes.
Cross-sectional study included 501 patients with type 2 diabetes. A standard 12-lead electrocardiogram was recorded. QT corrected for heart rate (QTc) >440 ms and QT dispersion (QTd) >80 ms were considered abnormally prolonged. QTc ≥ 500 ms was considered a high-risk QTc prolongation. Demographic, clinical and laboratory data were collected. Independent risk factors for prolonged QTc and QTd were assessed using logistic regression analysis.
Prevalence of QTc > 440 ms and QTd > 80 ms were 44.1 and 3.6 %, respectively. Prevalence of high-risk QTc (≥500 ms) was 2 % only. Independent risk factors for QTc prolongation >440 ms were mean blood glucose (β = 2.192, p < 0.001), treatment with sulphonylurea (β = 5.198, p = 0.027), female gender (β = 8.844, p < 0.001), and coronary heart disease (β = 8.636, p = 0.001). Independent risk factors for QTc ≥ 500 ms were coronary heart disease (β = 4.134, p < 0.001) and mean blood glucose level (β = 1.735, p < 0.001). The independent risk factor for prolonged QTd was only coronary heart disease (β = 5.354, p < 0.001).
Although the prevalence of prolonged QTc > 440 ms is significant, the prevalence of high-risk QTc (≥500 ms) and QTd > 80 ms is very low in patients with type 2 diabetes. Hyperglycaemia and coronary heart disease are strong predictors of high-risk QTc.
QT间期延长与心律失常及心源性猝死相关。本研究旨在确定2型糖尿病患者中QT间期延长和QT离散度的患病率，并明确其临床和代谢预测因素。
横断面研究纳入了501例2型糖尿病患者。记录标准12导联心电图。心率校正后的QT（QTc）>440毫秒和QT离散度（QTd）>80毫秒被视为异常延长。QTc≥500毫秒被视为高危QTc延长。收集人口统计学、临床和实验室数据。使用逻辑回归分析评估QTc和QTd延长的独立危险因素。
QTc>440毫秒和QTd>80毫秒的患病率分别为44.1%和3.6%。高危QTc（≥500毫秒）的患病率仅为2%。QTc延长>440毫秒的独立危险因素为平均血糖（β=2.192，p<0.001）、磺脲类药物治疗（β=5.198，p=0.027）、女性（β=8.844，p<0.001）和冠心病（β=8.636，p=0.001）。QTc≥500毫秒的独立危险因素为冠心病（β=4.134，p<0.001）和平均血糖水平（β=1.735，p<0.001）。QTd延长的独立危险因素仅为冠心病（β=5.354，p<0.001）。
尽管2型糖尿病患者中QTc>440毫秒的患病率较高，但高危QTc（≥500毫秒）和QTd>80毫秒的患病率非常低。高血糖和冠心病是高危QTc的有力预测因素。
