Background

Heart rate-corrected QT (QTc) interval is associated with increased risk for cardiovascular events and mortality among individuals with diabetes mellitus (DM). Little is known about the epidemiology of prolonged QTc among people with DM in resource-limited settings.

Methods

We conducted a cross-sectional study among adults with diabetes in ambulatory care at the Mbarara Regional Referral Hospital, from November 2018 to April 2019. Twelve-lead ECG recordings were performed on all participants. We collected clinical and laboratory data related to diabetes disease status and treatment control. We estimated QTc using Bazett’s formula and categorized it according to standardized sex-adjusted thresholds. Linear regression analysis was performed to identify correlates of QTc.

Results

We recruited 299 participants with a mean age of 50.1 years (SD±9.8) and mean HbA1c of 9.7 % (SD±2.6), and 69.6% were female. We detected prolonged and borderline QTc in 6.4% (19/299, 95% CI: 3.9–9.7%) and 23.4% (70/299, 95% CI: 18.7–28.6%) of participants, respectively. In multivariate models, factors associated with increasing QTc interval were mean arterial pressure (β=0.34; 95% CI: 0.07–0.63, p=0.019) and female sex (β=15.26; 95% CI: 7.58–22.94, p<0.001).

Conclusions

The prevalence of abnormal QTc among individuals in routine diabetes care in southwestern Uganda was high. Female sex and mean arterial pressure were correlated with QTc interval. Given these findings, future studies should explore the clinical impact of abnormal QTc in this patient population.

中文翻译：

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乌干达西南部糖尿病门诊患者中 QTc 间期延长的高患病率

背景

心率校正 QT (QTc) 间期与糖尿病 (DM) 患者心血管事件和死亡率的风险增加有关。在资源有限的环境中，DM 患者中 QTc 延长的流行病学知之甚少。

方法

我们于 2018 年 11 月至 2019 年 4 月在姆巴拉拉地区转诊医院对接受门诊护理的糖尿病成人进行了一项横断面研究。对所有参与者进行了 12 导联心电图记录。我们收集了与糖尿病疾病状态和治疗控制相关的临床和实验室数据。我们使用 Bazett 公式估计 QTc，并根据标准化的性别调整阈值对其进行分类。进行线性回归分析以确定 QTc 的相关性。

结果

我们招募了 299 名参与者，平均年龄为 50.1 岁 (SD±9.8)，平均 HbA1c 为 9.7 % (SD±2.6)，其中 69.6% 为女性。我们分别在 6.4% (19/299, 95% CI: 3.9–9.7%) 和 23.4% (70/299, 95% CI: 18.7–28.6%) 的参与者中检测到延长和临界 QTc。在多变量模型中，与 QTc 间期增加相关的因素是平均动脉压（β =0.34；95% CI：0.07-0.63，p =0.019）和女性（β =15.26；95% CI：7.58-22.94，p <0.001 ） ）。

结论

在乌干达西南部接受常规糖尿病护理的个体中 QTc 异常的患病率很高。女性和平均动脉压与 QTc 间期相关。鉴于这些发现，未来的研究应探讨异常 QTc 对该患者群体的临床影响。