Ragavan Niranjan, Thavalam Rida, Moorthy Swathy
Internal Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2024 Apr 14;16(4):e58233. doi: 10.7759/cureus.58233. eCollection 2024 Apr.
Background and aim The growing number of people with diabetes mellitus (DM) across the world is a public health concern. The diabetes epidemic involves enormous health costs to the patients, their careers, and society at large. Cardiovascular diseases such as atrial fibrillation (AF) often develop in the diabetic population. An increase in the P wave dispersion (PWD) has been established as an independent risk factor for the occurrence of AF, hence the present study was conducted to establish a possible relationship between PWD and the glycemic status of the individual to predict the occurrence of AF ahead of clinical symptomology. Methodology A comparative cross-sectional study was conducted at a tertiary care hospital after obtaining approval from the institutional ethics committee and written consent of each study subject. The main steps included the selection and categorization of the study population based on their glycemic status, collection of demographic data, performing ECGs calculating PWD using digital calipers, and recording the data systematically for evaluation. Results In this study, 234 patients with a mean age of 53.3 ± 13.1 years were studied, of which 121 (51.7%) were male and 113 (48.29%) were female. The 234 patients were divided into four groups based on their glycemic status - 74 uncontrolled DM patients (31.62%), 51 type 2 DM (T2DM) patients (21.78%), 56 prediabetes patients (23.93%), and 53 patients in the control group (22.64%; not a known case of diabetes with normal HbA1c and fasting blood sugar (FBS) levels). Minimal correlation was observed between FBS with PWD (r value 0.175) and age with PWD (r value 0.161), but statistical significance was observed only between age and PWD (p-value 0.014). The difference in means between the four different study groups was found to be not statistically significant (p-value- 0.104); hence, no intergroup variation was noted. Conclusion Advancing age and higher fasting blood sugars have shown minimal correlation with widening P-wave dispersion. With further studies involving larger populations, this can be a promising aid in identifying PWD as a probable early predictor of atrial arrhythmias among diabetic patients.
背景与目的 全球糖尿病患者人数不断增加,这是一个公共卫生问题。糖尿病流行给患者、其职业以及整个社会带来了巨大的健康成本。心房颤动(AF)等心血管疾病常在糖尿病患者中发生。P波离散度(PWD)增加已被确认为AF发生的独立危险因素,因此本研究旨在确定PWD与个体血糖状态之间的可能关系,以便在临床症状出现之前预测AF的发生。
方法 在获得机构伦理委员会批准并征得每位研究对象的书面同意后,在一家三级护理医院进行了一项比较性横断面研究。主要步骤包括根据研究人群的血糖状态进行选择和分类、收集人口统计学数据、进行心电图检查、使用数字卡尺计算PWD,并系统记录数据以进行评估。
结果 本研究共纳入234例患者,平均年龄为53.3±13.1岁,其中男性121例(51.7%),女性113例(48.29%)。根据血糖状态,234例患者被分为四组——74例血糖控制不佳的糖尿病患者(31.62%)、51例2型糖尿病(T2DM)患者(21.78%)、56例糖尿病前期患者(23.93%)和53例对照组患者(22.64%;非已知糖尿病病例,糖化血红蛋白(HbA1c)和空腹血糖(FBS)水平正常)。FBS与PWD之间(r值为0.175)以及年龄与PWD之间(r值为0.161)观察到最小相关性,但仅年龄与PWD之间具有统计学意义(p值为0.014)。发现四个不同研究组之间的均值差异无统计学意义(p值为0.104);因此,未观察到组间差异。
结论 年龄增长和空腹血糖升高与P波离散度增宽的相关性极小。通过涉及更多人群的进一步研究,这可能成为识别PWD作为糖尿病患者房性心律失常可能早期预测指标的有前景的辅助手段。