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Correlation Between QTc Prolongation and Obstructive Sleep Apnea in Patients with Type 2 Diabetes Mellitus

Huan Shi, Xiaohong Jiang

Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)

Med Sci Monit 2020; 26:e926954

DOI: 10.12659/MSM.926954

Available online: 2020-08-21

Published: 2020-08-27

BACKGROUND: Obstructive sleep apnea (OSA) plays an important role in the progression of cardiovascular disease (CVD), and is a common symptom in patients with type 2 diabetes mellitus (T2DM). Prolongation of corrected QT interval (QTc) reflects ventricular arrhythmias and CVD.
The aim of this study was to explore the relationship between OSA and QTc in T2DM patients and to evaluate the potential application of QTc in clinical practice.
MATERIAL AND METHODS: A total of 358 T2DM patients were involved in this study. OSA was diagnosed with apnea-hypopnea index ≥5 by full-night polysomnography and QTc was measured by a 12-lead electrocardiogram (ECG). Patients were grouped into 2 groups based on median QTc, and clinical data were studied. Logistic regression analysis was used to investigate the association between OSA and QTc with adjusted age, sex, body mass index (BMI), hypertension, total bilirubin (TBL), and smoking history.
RESULTS: Among 358 T2DM patients, 59.2% had OSA. Compared to those in the QTc <418 ms group, older patients, females, patients with higher BMI, and OSA patients in the QTc ≥418 ms group were more likely to have OSA (p<0.05). Correlation analysis suggested that OSA was associated with longer QTc (OR: 2.355, 95% CI: 1.529-3.626, p<0.001). For T2DM patients with QTc ≥418 ms, older patients (OR: 1.042, 95% CI: 1.042-1.064, p<0.001), females (OR: 2.36, 95% CI: 1.371-4.063, p<0.01), and patients with higher BMI (OR: 1.113, 95% CI: 1.037-1.195, p<0.01) were significantly more likely to have OSA.
CONCLUSIONS: In this cross-sectional study, we found that the presence and severity of OSA was associated with QTc prolongation in 358 patients with T2DM, and age, female sex, and BMI appear to be independent risk factors for OSA and CVD.

Keywords: Cardiovascular Diseases, Diabetes Mellitus, Type 2, Electrocardiography, Sleep Apnea Syndromes