Selective association of electrocardiographic abnormalities with insulin sensitivity and beta-cell function in type 2 diabetes mellitus: a cross-sectional analysis.

Bhatt, Anish B.; Mulvey, Claire K.; Qasim, Atif N.; Nair, Jayamohan V.; Rickels, Michael R.; Prenner, Stuart B.; Iqbal, Nayyar; Reilly, Muredach P.

<bold>Background: </bold>We investigated the association of electrocardiographic (ECG) abnormalities with markers of insulin resistance and pancreatic beta-cell dysfunction in a cross-sectional study of type 2 diabetes patients.<bold>Methods: </bold>Electrocardiographic criteria were evaluated in the Penn Diabetes Heart Study participants (n = 1671; 64% male; 61% Caucasian), including a sub-sample (n = 710) that underwent oral glucose tolerance testing. The Matsuda Insulin Sensitivity Index and homeostasis model assessment of insulin resistance (HOMA-IR) estimated insulin sensitivity; Insulinogenic Index and homeostasis model assessment of beta-cell function assessed beta-cell function. Multivariable regression modelling was used to analyse associations of ECG changes with these indices.<bold>Results: </bold>In unadjusted analyses, subjects in the highest quartile of Matsuda index had the lowest prevalence of Q-waves (6.3% versus 15.3%, p = 0.005). In adjusted models, an inverse association was seen between Q-waves and log Matsuda index [one standard deviation increase; OR = 0.59 (95% CI 0.43-0.87 p = 0.001)]. In the full Penn Diabetes Heart Study, there was a direct association between Q-waves and HOMA-IR [one standard deviation increase; OR = 1.43 (95% CI 1.13-1.81, p = 0.003)]. In adjusted models, left ventricular hypertrophy also was inversely associated with Matsuda index and directly with HOMA-IR. Higher Insulinogenic Index scores were associated with a lower prevalence of nonspecific ST changes [OR = 0.78 (95% CI 0.62-0.98, p = 0.032)].<bold>Conclusions: </bold>In type 2 diabetic patients, both oral glucose tolerance testing-derived and HOMA-derived measures of insulin resistance were associated with pathologic Q-waves and left ventricular hypertrophy on ECGs. Copyright © 2016 John Wiley & Sons, Ltd.

BLOOD sugar analysis; INSULIN therapy; HYPOGLYCEMIC agents; TYPE 2 diabetes complications; CARDIOVASCULAR diseases; ELECTROCARDIOGRAPHY; GLUCOSE tolerance tests; GLYCOSYLATED hemoglobin; INSULIN resistance; ISLANDS of Langerhans; LONGITUDINAL method; TYPE 2 diabetes; PROGNOSIS; CROSS-sectional method

Diabetes/Metabolism Research & Reviews, 2016, Vol 32, Issue 7, p736

1520-7552

Academic Journal

10.1002/dmrr.2794