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The association of the metabolic syndrome with QTc interval in NHANES III

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Abstract

Purpose To examine the relationship of metabolic syndrome with corrected QT interval duration. Methods In a cross-sectional analysis of NHANES III, a representative sample of the adult US population, 3,495 individuals aged ≥40 years were categorized as having metabolic syndrome and not having metabolic syndrome as defined by ATP III. QT interval was measured from the standard 12-lead electrocardiogram. Results A weighted multi-linear regression analysis adjusted for age, gender, serum calcium, and potassium showed that metabolic syndrome was significantly associated with a corrected QT interval in milliseconds. The adjusted Beta coefficient and its corresponding standard error were (4.48 milliseconds, 0.95 milliseconds, P < 0.01). Conclusion These data indicate that metabolic syndrome is independently associated with a corrected QT interval duration. This study calls for careful ECG monitoring among persons with metabolic syndrome for early detection of a long corrected QT interval in order to prevent severe and often fatal arrhythmias.

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References

  1. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third national health and nutrition examination survey. JAMA. 2002;287(3):356–9.

    Article  PubMed  Google Scholar 

  2. Gogia A, Agarwal PK. Metabolic syndrome. Indian J Med Sci. 2006;60(2):72–81.

    Article  PubMed  Google Scholar 

  3. Lahoz C, Vicente I, Laguna F, Garcia-Iglesias MF, Taboada M, Mostaza JM. Metabolic syndrome and asymptomatic peripheral artery disease in subjects over 60 years of age. Diabetes Care. 2006;29(1):148–50.

    Article  PubMed  Google Scholar 

  4. Malik S, Wong ND, Franklin SS, Kamath TV, L’Italien GJ, Pio JR, et al. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation. 2004;110(10):1245–50.

    Article  PubMed  Google Scholar 

  5. Soydinc S, Davutoglu V, Akcay M. Uncomplicated metabolic syndrome is associated with prolonged electrocardiographic QTc interval and QTc dispersion. Ann Noninvasive Electrocardiol. 2006;11(4):313–7.

    Article  PubMed  Google Scholar 

  6. Rebeiz AG, Al-Khatib SM. A case of severe ischemia-induced QT prolongation. Clin Cardiol. 2001;24(11):750.

    PubMed  CAS  Google Scholar 

  7. Straus SM, Kors JA, De Bruin ML, van der Hooft CS, Hofman A, Heeringa J, et al. Prolonged QTc interval and risk of sudden cardiac death in a population of older adults. J Am Coll Cardiol. 2006;47(2):362–7.

    Article  PubMed  Google Scholar 

  8. Sharp DS, Masaki K, Burchfiel CM, Yano K, Schatz IJ. Prolonged QTc interval, impaired pulmonary function, and a very lean body mass jointly predict all-cause mortality in elderly men. Ann Epidemiol. 1998;8(2):99–106.

    Article  PubMed  CAS  Google Scholar 

  9. Okin PM, Devereux RB, Howard BV, Fabsitz RR, Lee ET, Welty TK. Assessment of QT interval and QT dispersion for prediction of all-cause and cardiovascular mortality in American Indians: The Strong Heart Study. Circulation. 2000;101(1):61–6.

    PubMed  CAS  Google Scholar 

  10. Nakanishi S, Yamada M, Hattori N, Suzuki G. Relation between QT duration and mortality in an elderly Japanese population. Am J Cardiol. 2004;93(9):1182–5.

    Article  PubMed  Google Scholar 

  11. Rautaharju PM, Nelson JC, Kronmal RA, Zhang ZM, Robbins J, Gottdiener JS, et al. Usefulness of T-axis deviation as an independent risk indicator for incident cardiac events in older men and women free from coronary heart disease (the Cardiovascular Health Study). Am J Cardiol. 2001;88(2):118–23.

    Article  PubMed  CAS  Google Scholar 

  12. Cubeddu LX. QT prolongation and fatal arrhythmias: a review of clinical implications and effects of drugs. Am J Ther. 2003;10(6):452–7.

    Article  PubMed  Google Scholar 

  13. Roden DM. Drug-induced prolongation of the QT interval. N Engl J Med. 2004;350(10):1013–22.

    Article  PubMed  CAS  Google Scholar 

  14. Liu XK, Katchman A, Drici MD, Ebert SN, Ducic I, Morad M, et al. Gender difference in the cycle length-dependent QT and potassium currents in rabbits. J Pharmacol Exp Ther. 1998;285(2):672–9.

    PubMed  CAS  Google Scholar 

  15. National Center for Health Statistics. Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–94. Series 1: Programs and collection procedures. Vital Health Stat. 1994;1:1–407.

    Google Scholar 

  16. Neeley WE. Simple automated determination of serum or plasma glucose by a hexokinase-glucose-6-phosphate dehydrogenase method. Clin Chem. 1972;18(6):509–15.

    PubMed  CAS  Google Scholar 

  17. Gunter EW, Lewis B, Koncikowski SM. Laboratory procedures used for the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994 Centers for Disease Control and Prevention. Hyattsville, MD; 1996

  18. Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Arterioscler Thromb Vasc Biol. 2004;24(2):e13–8.

    Article  PubMed  CAS  Google Scholar 

  19. Cardenas VM, Graham DY. Smoking and Helicobacter pylori infection in a sample of U.S. adults. Epidemiology. 2005;16(4):586–90.

    Article  PubMed  Google Scholar 

  20. Weitzman M, Cook S, Auinger P, Florin TA, Daniels S, Nguyen M, et al. Tobacco smoke exposure is associated with the metabolic syndrome in adolescents. Circulation. 2005;112(6):862–9.

    Article  PubMed  CAS  Google Scholar 

  21. Benoit SR, Mendelsohn AB, Nourjah P, Staffa JA, Graham DJ. Risk factors for prolonged QTc among US adults: Third National Health and Nutrition Examination Survey. Eur J Cardiovasc Prev Rehabil. 2005;12(4):363–8.

    Article  PubMed  Google Scholar 

  22. Fridericia LS. The duration of systole in an electrocardiogram in normal humans and in patients with heart disease. 1920. Ann Noninvasive Electrocardiol. 2003;8(4):343–51.

    Article  PubMed  CAS  Google Scholar 

  23. Bellavere F, Ferri M, Guarini L, Bax G, Piccoli A, Cardone C, et al. Prolonged QT period in diabetic autonomic neuropathy: a possible role in sudden cardiac death? Br Heart J. 1988;59(3):379–83.

    Article  PubMed  CAS  Google Scholar 

  24. Dekker JM, Schouten EG, Klootwijk P, Pool J, Kromhout D. Association between QT interval and coronary heart disease in middle-aged and elderly men. The Zutphen study. Circulation. 1994;90(2):779–85.

    PubMed  CAS  Google Scholar 

  25. Schouten EG, Dekker JM, Meppelink P, Kok FJ, Vandenbroucke JP, Pool J. QT interval prolongation predicts cardiovascular mortality in an apparently healthy population. Circulation. 1991;84(4):1516–23.

    PubMed  CAS  Google Scholar 

  26. Leclercq B, Jaimes EA, Raij L. Nitric oxide synthase and hypertension. Curr Opin Nephrol Hypertens. 2002;11(2):185–9.

    Article  PubMed  Google Scholar 

  27. Ahnve S. QT interval prolongation in acute myocardial infarction. Eur Heart J. 1985;6 (Suppl D):85–95

    Google Scholar 

  28. Ahnve S. Correction of the QT interval for heart rate: review of different formulas and the use of Bazett’s formula in myocardial infarction. Am Heart J. 1985;109(3 Pt 1):568–74.

    Article  PubMed  CAS  Google Scholar 

  29. Alonso JL, Martinez P, Vallverdu M, Cygankiewicz I, Pitzalis MV, Bayes Genis A, et al. Dynamics of ventricular repolarization in patients with dilated cardiomyopathy versus healthy subjects. Ann Noninvasive Electrocardiol. 2005;10(2):121–8.

    Article  PubMed  Google Scholar 

  30. Milliez P, Leenhardt A, Maisonblanche P, Vicaut E, Badilini F, Siliste C, et al. Usefulness of ventricular repolarization dynamicity in predicting arrhythmic deaths in patients with ischemic cardiomyopathy (from the European Myocardial Infarct Amiodarone Trial). Am J Cardiol. 2005;95(7):821–6.

    Article  PubMed  Google Scholar 

  31. Ford ES, Giles WH, Mokdad AH. Increasing prevalence of the metabolic syndrome among U.S. adults. Diabetes Care. 2004;27(10):2444–9.

    Article  PubMed  Google Scholar 

  32. Alexander CM, Landsman PB, Teutsch SM, Haffner SM, National Cholesterol Education Program N. NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes. 2003;52(5):1210–4.

    Article  PubMed  CAS  Google Scholar 

  33. Tong W, Lai H, Yang C, Ren S, Dai S, Lai S. Age, gender and metabolic syndrome-related coronary heart disease in U.S. adults. Int J Cardiol. 2005;104(3):288–91.

    Article  PubMed  Google Scholar 

  34. Haapanen N, Miilunpalo S, Pasanen M, Oja P, Vuori I. Agreement between questionnaire data and medical records of chronic diseases in middle-aged and elderly Finnish men and women. Am J Epidemiol. 1997;145(8):762–9.

    PubMed  CAS  Google Scholar 

  35. Tretli S, Lund-Larsen PG, Foss OP. Reliability of questionnaire information on cardiovascular disease and diabetes: cardiovascular disease study in Finnmark county. J Epidemiol Community Health. 1982;36(4):269–73.

    Article  PubMed  CAS  Google Scholar 

  36. Gonzalez MM, Cavalcanti TC, Vianna CB, Timerman S. Hypomagnesaemia causing QT interval prolongation and torsade de pointes in an alcoholic patient. Resuscitation. 2006;70(3):346–7.

    Article  PubMed  Google Scholar 

  37. Trevisani F, Merli M, Savelli F, Valeriano V, Zambruni A, Riggio O, et al. QT interval in patients with non-cirrhotic portal hypertension and in cirrhotic patients treated with transjugular intrahepatic porto-systemic shunt. J Hepatol. 2003;38(4):461–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Preventive medicine, Menufiya University, Menufiya, Egypt

    Mohammed F. Faramawi

  2. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, USA

    Rachel P. Wildman

  3. Department of Epidemiology, Tulane School of Public Health & Tropical Medicine (SPHTM), New Orleans, LA, USA

    Jeanette Gustat

  4. Department of Biostatistics, Tulane School of Public Health & Tropical Medicine (SPHTM), New Orleans, LA, USA

    Janet Rice

  5. Department of Internal Medicine, Menufiya University, Menufiya, Egypt

    Mohammed Y. Abdul Kareem

Authors
  1. Mohammed F. Faramawi
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  2. Rachel P. Wildman
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  3. Jeanette Gustat
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  4. Janet Rice
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  5. Mohammed Y. Abdul Kareem
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Correspondence to Mohammed F. Faramawi.

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Faramawi, M.F., Wildman, R.P., Gustat, J. et al. The association of the metabolic syndrome with QTc interval in NHANES III. Eur J Epidemiol 23, 459–465 (2008). https://doi.org/10.1007/s10654-008-9252-4

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  • DOI: https://doi.org/10.1007/s10654-008-9252-4

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