Zhou Yuling, Jelinek Herbert, Hambly Brett D, McLachlan Craig S
Rural Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia.
School of Community Health Sciences, Charles Sturt University, Albury, Australia.
J Electrocardiol. 2017 Jul-Aug;50(4):450-456. doi: 10.1016/j.jelectrocard.2017.02.010. Epub 2017 Feb 20.
Prolonged electrocardiogram QRS durations are often present in aging populations. Shorter telomere length is considered a biomarker of cellular aging. Decreased telomere length has been associated with coronary artery risk, and ventricular remodeling. However, the association between telomeres and cardiac conduction abnormalities, such as increased QRS duration are not well understood. A retrospective cross-sectional population was obtained from the CSU Diabetes Screening Research Initiative database where 273 participants had both ECG-derived QRS duration and DNA to permit leukocyte telomere length (LTL) determination. Telomere length was determined using the monochrome multiplex quantitative PCR method to measure mean relative LTL. Resting 12-lead electrocardiograms were obtained from each subject using a Welch Allyn PC-Based ECG system. Relative LTL was moderately negatively associated with QRS duration in type 2 diabetes mellitus (T2DM) patients (R=0.055), compared to controls (R=0.010). In general linear models with no adjustments a significant interaction between QRS duration and LTL is observed for a combined population of T2DM and non-diabetics. When we compared T2DM to non-diabetics, we found that T2DM increased the effect size for relative LTL on QRS duration in comparison to controls. Hence, for each 0.1 unit of relative LTL attrition, QRS duration in T2DM patients increased by 3.24ms (95% CI, -63.00 to -1.84), compared to 1.65ms in controls (95% CI, -40.44 to 7.40). In summary we have observed an association between LTL in a rural aging mixed population of T2DM and non-diabetes. We have observed an unadjusted association between QRS duration and LTL in T2DM. We noted that the control group demonstrated no such association. This highlights the complexity of T2DM when exploring disease phenotype-telomere interactions.
心电图QRS波时限延长在老年人群中较为常见。较短的端粒长度被认为是细胞衰老的生物标志物。端粒长度缩短与冠状动脉风险及心室重构有关。然而，端粒与心脏传导异常（如QRS波时限增加）之间的关联尚不清楚。我们从科罗拉多州立大学糖尿病筛查研究倡议数据库中获取了一个回顾性横断面人群，其中273名参与者同时拥有心电图衍生的QRS波时限和用于测定白细胞端粒长度（LTL）的DNA。使用单色多重定量PCR方法测定端粒长度，以测量平均相对LTL。使用基于Welch Allyn电脑的心电图系统从每个受试者获取静息12导联心电图。与对照组（R = 0.010）相比，2型糖尿病（T2DM）患者的相对LTL与QRS波时限呈中度负相关（R = 0.055）。在未进行调整的一般线性模型中，观察到T2DM患者和非糖尿病患者的合并人群中QRS波时限与LTL之间存在显著交互作用。当我们将T2DM患者与非糖尿病患者进行比较时，我们发现与对照组相比，T2DM增加了相对LTL对QRS波时限的效应大小。因此，每0.1单位相对LTL损耗，T2DM患者的QRS波时限增加3.24ms（95%CI，-63.00至-1.84），而对照组为1.65ms（95%CI，-40.44至7.40）。总之，我们在农村老年T2DM和非糖尿病混合人群中观察到LTL与QRS波时限之间存在关联。我们在T2DM患者中观察到QRS波时限与LTL之间存在未调整的关联。我们注意到对照组未显示出这种关联。这凸显了在探索疾病表型-端粒相互作用时T2DM的复杂性。
