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The association of long-term glycaemic variability versus sustained chronic hyperglycaemia with heart rate-corrected QT interval in patients with type 2 diabetes

Author

Listed:
  • Jian-bin Su
  • Xiao-hua Yang
  • Xiu-lin Zhang
  • Hong-li Cai
  • Hai-yan Huang
  • Li-hua Zhao
  • Feng Xu
  • Tong Chen
  • Xing-bo Cheng
  • Xue-qin Wang
  • Yan Lu

Abstract

Objectives: Prolonged heart rate-corrected QT(QTc) interval is related to ventricular arrhythmia and cardiovascular mortality, with considerably high prevalence of type 2 diabetes. Additionally, long-term glycaemic variability could be a significant risk factor for diabetic complications in addition to chronic hyperglycaemia. We compared the associations of long-term glycaemic variability versus sustained chronic hyperglycaemia with the QTc interval among type 2 diabetes patients. Methods: In this cross-sectional study, 2904 type 2 diabetes patients were recruited who had undergone at least four fasting plasma glucose (FPG) and 2-hour postprandial plasma glucose (PPG) measurements (at least once for every 3 months, respectively) during the preceding year. Long-term glycaemic variabilities of FPG and 2-hour PPG were assessed by their standard deviations (SD-FPG and SD-PPG, respectively), and chronic fasting and postprandial hyperglycaemia were assessed by their means (M-FPG and M-PPG, respectively). HbA1c was also determined upon enrolment to assess current overall glycaemic control. QTc interval was estimated from resting 12-lead electrocardiograms, and more than 440 ms was considered abnormally prolonged. Results: Patients with prolonged QTc interval (≥440 ms) had greater M-FPG, M-PPG, SD-PPG and HbA1c than those with normal QTc interval but comparable SD-FPG. QTc interval was correlated with M-FPG, M-PPG, SD-PPG and HbA1c (r = 0.133, 0.153, 0.245 and 0.207, respectively, p = 0.000) but not with SD-FPG (r = 0.024, p = 0.189). After adjusting for metabolic risk factors via multiple linear regression analysis, SD-PPG, M-PPG and HbA1c (t = 12.16, 2.69 and 10.16, respectively, p = 0.000) were the major independent contributors to the increased QTc interval. The proportion of prolonged QTc interval increased significantly from 10.9% to 14.2% to 26.6% for the first (T1) to second (T2) to third (T3) tertiles of SD-PPG. After adjusting via multiple logistic regression analysis, the odd ratios of prolonged QTc interval of the T2 and T3 versus the T1 of SD-PPG were 1.15 (95% CI, 0.82–1.60) and 2.62 (1.92–3.57), respectively. Conclusions: Increased long-term variability of PPG is a strong independent risk factor for prolonged QTc interval in type 2 diabetes patients, in addition to long-term postprandial hyperglycaemia and current HbA1c.

Suggested Citation

  • Jian-bin Su & Xiao-hua Yang & Xiu-lin Zhang & Hong-li Cai & Hai-yan Huang & Li-hua Zhao & Feng Xu & Tong Chen & Xing-bo Cheng & Xue-qin Wang & Yan Lu, 2017. "The association of long-term glycaemic variability versus sustained chronic hyperglycaemia with heart rate-corrected QT interval in patients with type 2 diabetes," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-12, August.
    • Handle: RePEc:plo:pone00:0183055
    DOI: 10.1371/journal.pone.0183055
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    References listed on IDEAS

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    1. Michael Brownlee, 2001. "Biochemistry and molecular cell biology of diabetic complications," Nature, Nature, vol. 414(6865), pages 813-820, December.
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