Cigarette Smoking Is Associated with Prolongation of the QTc Interval Duration in Patients with Type 2 Diabetes Mellitus

Θωμάκος, Πέτρος; Liatis, Stavros; Kalopita, Stavroula; Vlahodimitris, Ioannis; Stathi, C.; Katsilambros, Nicholas; Tentolouris, Nikolaοs; Makrilakis, Konstantinos

doi:10.1155/2013/329189

Cited by 14 publications

(11 citation statements)

References 27 publications

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“…The results of our study pointed to low educational level of residents in TGRR, with half of the participants being lower than primary school. Furthermore, the results revealed that smoking is an independent risk for diabetes in men as shown earlier [ 32 – 35 ]. Therefore, it is essential to conduct effective behavioral intervention programs to promote healthy ways of life in citizens, such as peer support on smoking cessation especially for people with lower education level.…”

Section: Discussionsupporting

confidence: 76%

Prevalence of diabetes and impaired fasting glucose among residents in the Three Gorges Reservoir Region, China

Feng

Ding³

et al. 2014

BMC Public Health

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BackgroundThe Three Gorges Dam in China is the world’s largest hydro-electric scheme in the contemporary world. After the construction of the Dam, great changes took place on the residents’ lifestyles characterized by reduced physical activity due to the loss of arable land and a series of psychological problems caused by resettlement, which might be regarded as contributing factors to the development of diabetes in Three Gorges Reservoir Region (TGRR). However, there is no study that has been conducted targeting large population samples with the aim of determining the prevalence of diabetes in TGRR. This study purposed to estimate the prevalence of diabetes and impaired fasting glucose (IFG) in the adult population ≥18 years in TGRR and to evaluate the associated risk factors.MethodsA total of 3721 randomly selected adults, aged ≥18 years and having lived in TGRR for at least one year, participated in questionnaire-based interview from April to May 2013 and had their physical examinations and standard glucose taken. 75 g oral glucose tolerance test (OGTT) was conducted on the subjects with fasting glucose levels being ≥ 5.6 mmol/L. Diabetes and IFG were defined according to WHO 1999 criteria.ResultsThe age-standardized prevalence of diabetes and IFG were 7.6% (7.9% among men and 7.4% among women) and 9.0% (9.1% among men and 8.9% among women), respectively. Among the identified cases of diabetes in this study, 54.46% (171/314) were newly diagnosed. The prevalence of diabetes cases rose with age (4.0%, 4.5%, 8.1%, 11.2%, 12.4% and 12.9% among persons who were 18 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69 and ≥ 70 years of age, respectively). The results of multivariate logistic-regression analyses showed that the diabetes was significantly linked to age, family history of diabetes, central obesity, educational level and hypertension for both men and women. In addition, smoking was significantly associated with diabetes in men.ConclusionsDiabetes has become a major public health problem in the TGRR with a large number of the cases undiagnosed. These results suggest that regular population-based diabetes screening should be conducted to identify early-stage diabetes and integrated strategies aimed at the prevention and treatment of diabetes initiated.

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Section: Discussionsupporting

confidence: 76%

Prevalence of diabetes and impaired fasting glucose among residents in the Three Gorges Reservoir Region, China

Feng

Ding³

et al. 2014

BMC Public Health

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“…The finding of the present study agreed with previous studies. 18 , 33 , 34 Contrary to the present study, Devi et al, 23 showed that there was no significant difference in QT interval between smokers and non-smokers. In the present study, 9 out of 30 (30%) smokers and 2 out of 30 (6.7%) non-smokers had prolonged QTc interval (>440 ms).…”

Section: Discussioncontrasting

confidence: 87%

Relationship between Plasma Adiponectin Level and Corrected QT interval in Smoker and Non-Smoker Adult Male Subjects

Theint¹,

Khin²,

Thein³

et al. 2020

JAFES

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Objective. This study determined the relationship between plasma adiponectin level and corrected QT interval (QTc) in smokers and non-smokers. Methodology. This cross-sectional analytical study was undertaken in 30 smokers and 30 non-smokers. Plasma adiponectin level was determined by enzyme-linked immunosorbent assay (ELISA). The QT interval was measured by routine 12-lead ECG with Lead II rhythm and QTc was calculated. Results. Mean plasma adiponectin level was significantly lower in smokers (27.89±15 μg/ml) than that of non-smokers (52.13±21.57μg/ml) (p<0.001). Mean QTc interval was significantly longer in smokers than that of non-smokers (415.37±29.9 versus 395.63±26.13 ms, p<0.01). Higher risk of low adiponectin level (odds ratio [OR],8.1; 95% confidence interval [CI],1.61-40.77) and QTc interval prolongation (OR,6; 95%CI,1.17-30.73) were observed in smokers. There was weak significant negative correlation between plasma adiponectin level and QTc interval in the study population (n=60, r=-0.407, p=0.001). Moreover, low plasma adiponectin level was significantly associated with prolonged QTc interval in the study population (n=60, Fisher's exact p value<0.05). Risk of QTc interval prolongation was 4.3 times higher in subjects with low plasma adiponectin level (OR,4.27; 95% CI,1.05-17.46). Conclusion. Smokers have greater risk for low plasma adiponectin level and prolonged QTc interval. There is a relationship between plasma adiponectin level and QTc interval.

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“…Accumulating evidences had demonstrated that hyperglycaemia and coexisting confounders in diabetes may promote the increases in QTc interval. Increased QTc interval may be related to cigarette smoking [ 32 ], obesity [ 4 ], nonalcoholic fatty liver disease [ 30 ], hypertension [ 33 ], dyslipidaemia [ 6 ], uric acid (UA) [ 34 ], insulin resistance and its associated hyperinsulinaemia [ 35 ], glycaemic status [ 36 ], coronary artery disease, carotid intima media thickness, diabetic neuropathy, diabetic retinopathy, and diabetic cardiomyopathy [ 1 , 9 , 37 ]. In the present study, hypertension, UA and nonmodifiable factors including age and sex were observed to be independently associated with increased QTc interval.…”

Section: Discussionmentioning

confidence: 99%

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

Yang

Zhang

et al. 2017

PLoS ONE

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ObjectivesProlonged 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.MethodsIn 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.ResultsPatients 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.ConclusionsIncreased 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.

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Cigarette Smoking Is Associated with Prolongation of the QTc Interval Duration in Patients with Type 2 Diabetes Mellitus

Cited by 14 publications

References 27 publications

Prevalence of diabetes and impaired fasting glucose among residents in the Three Gorges Reservoir Region, China

Prevalence of diabetes and impaired fasting glucose among residents in the Three Gorges Reservoir Region, China

Relationship between Plasma Adiponectin Level and Corrected QT interval in Smoker and Non-Smoker Adult Male Subjects

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

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