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Heart rate-corrected QT interval in resting ECG predicts the risk for development of type-2 diabetes mellitus

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Abstract

Chronic and subclinical sympathetic over-activity may underlie development of type-2 diabetes mellitus (DM). Since longer heart rate-corrected QT interval (QTc) represents predominance of sympathetic activity within autonomic balance, we investigated influences of QTc on the incidence of DM in a follow-up study. The subjects were 12,530 men and 7,163 women aged 30–59 years and apparently healthy at baseline. QTc in resting ECG was obtained using Bazett’s formula (QTcB), Fridericia’s formula (QTcF) and the linear regression technique (QTcLR). Incident DM was identified by ‘fasting serum glucose ≥7.00 mmol l−1 (126 mg dl−1)’ or/and ‘on medication for DM’. Using Cox proportional hazard models, hazard ratio (HR) for incident DM was estimated according to the quartiles (Q1–Q4) of QTcB, QTcF or QTcLR, and its linear trends across the quartiles were checked. Baseline age, BMI, smoking, drinking, exercise and education were computed as conventional confounders. During the follow-up of 93,337 person-years for men and 51,517 person-years for women, 637 men and 192 women developed DM. The multivariate-adjusted HRs(95% confidence interval) for Q4 of QTcB, QTcF and QTcLR against corresponding Q1 were 1.85(1.46, 2.34), 1.31(1.04, 1.65) and 1.58(1.26, 1.99), respectively, for men, and 2.03(1.31, 3.16), 1.34(0.91, 2.00) and 1.58(1.04, 2.38), respectively, for women. Both sexes showed increasing trends in the HRs across the quartiles of QTcB, QTcF and QTcLR. In conclusion, QTc in resting ECG moderately but proportionally predicts the risk for development of DM in middle-aged healthy men and women. Moreover, the adverse effects of prolonged QTc are independent of those of conventional risk factors.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

DM:

type-2 diabetes mellitus

FSG:

Fasting serum glucose

HR:

Hazard ratio

Q1, Q2, Q3 and Q4:

1st, 2nd, 3rd and 4th quartile, respectively

QTc:

Heart rate-corrected QT interval

QTcB:

QTc by Bazett’s formula

QTcF:

QTc by Fridericia’s formula

QTcLR:

QTc by the linear regression technique

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Acknowledgments

This study was supported by a Grant-in-Aid for Scientific Research (B) from the Ministry of Education, Culture, Sports, Science and Technology (14370141) and by a grant from Smoking Research Foundation (Tokyo, Japan).

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Authors and Affiliations

  1. Department of Public Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Teruo Nagaya

  2. Department of Epidemiology, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-machi, Itabashi-ku, Tokyo, 173-0015, Japan

    Hideyo Yoshida

  3. Gifu Prefectural Center for Health Check and Health Promotion, 4-6-2 Noisshiki, Gifu-shi, Gifu, 500-8226, Japan

    Hidekatsu Takahashi & Makoto Kawai

Authors
  1. Teruo Nagaya
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  2. Hideyo Yoshida
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  3. Hidekatsu Takahashi
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  4. Makoto Kawai
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Corresponding author

Correspondence to Teruo Nagaya.

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Nagaya, T., Yoshida, H., Takahashi, H. et al. Heart rate-corrected QT interval in resting ECG predicts the risk for development of type-2 diabetes mellitus. Eur J Epidemiol 25, 195–202 (2010). https://doi.org/10.1007/s10654-009-9423-y

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  • DOI: https://doi.org/10.1007/s10654-009-9423-y

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