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Association of nonalcoholic fatty liver disease with QTc interval in patients with type 2 diabetes.

Association of nonalcoholic fatty liver disease with QTc interval in patients with type 2 diabetes.
Association of nonalcoholic fatty liver disease with QTc interval in patients with type 2 diabetes.
Background and aims: the relationship between nonalcoholic fatty liver disease (NAFLD) and prolonged heart rate-corrected QT (QTc) interval, a risk factor for ventricular arrhythmias and sudden cardiac death, is currently unknown. We therefore examined the relationship between NAFLD and QTc interval in patients with type 2 diabetes.

Methods and results: we studied a random sample of 400 outpatients with type 2 diabetes. Computerized electrocardiograms were performed for analysis and quantification of QTc interval. NAFLD was diagnosed by ultrasonographic detection of hepatic steatosis in the absence of other liver diseases. Mean QTc interval and the proportion of those with increased QTc interval (defined as either QTc interval above the median, i.e. ?416 ms, or QTc interval >440 ms) increased steadily with the presence and ultrasonographic severity of NAFLD. NAFLD was associated with increased QTc interval (odds ratio [OR] 2.16, 95% CI 1.4–3.4, p < 0.001). Adjustments for age, sex, smoking, alcohol consumption, BMI, hypertension, electrocardiographic left ventricular hypertrophy, diabetes-related variables and comorbid conditions did not attenuate the association between NAFLD and increased QTc interval (adjusted-OR 2.26, 95% CI 1.4–3.7, p < 0.001). Of note, the exclusion of those with established coronary heart disease or peripheral artery disease from analysis did not appreciably weaken this association.

Conclusion: this is the first study to demonstrate that the presence and severity of NAFLD on ultrasound is strongly associated with increased QTc interval in patients with type 2 diabetes even after adjusting for multiple established risk factors and potential confounders
1590-3729
663-669
Targher, G.
5a842bd2-91c4-4063-b639-da6c681f3698
Valbusa, F.
d9aafe28-7ce5-4893-af8c-4ece09ddc2e2
Bonapace, S.
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Bertolini, L.
98d540f4-9422-4c2c-92d1-2383c3798ca3
Zenari, L.
3caeb6f8-b4ee-477d-8fdc-661a773204ad
Pichiri, I.
c11e89f0-30d4-4321-991e-935397041fd8
Mantovani, A.
b1382b57-9c74-44b8-8516-c1d82f2eeb2f
Zoppini, G.
21719d3f-197a-43ba-a955-366ea9ac0764
Bonora, E.
808afaf8-dcf2-4986-95d2-342691094b8e
Barbieri, E.
4b14a825-8c81-4b4b-8104-f37d68f89356
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Targher, G.
5a842bd2-91c4-4063-b639-da6c681f3698
Valbusa, F.
d9aafe28-7ce5-4893-af8c-4ece09ddc2e2
Bonapace, S.
3bf688b2-0f7e-4e5b-8011-c353a93bf675
Bertolini, L.
98d540f4-9422-4c2c-92d1-2383c3798ca3
Zenari, L.
3caeb6f8-b4ee-477d-8fdc-661a773204ad
Pichiri, I.
c11e89f0-30d4-4321-991e-935397041fd8
Mantovani, A.
b1382b57-9c74-44b8-8516-c1d82f2eeb2f
Zoppini, G.
21719d3f-197a-43ba-a955-366ea9ac0764
Bonora, E.
808afaf8-dcf2-4986-95d2-342691094b8e
Barbieri, E.
4b14a825-8c81-4b4b-8104-f37d68f89356
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c

Targher, G., Valbusa, F., Bonapace, S., Bertolini, L., Zenari, L., Pichiri, I., Mantovani, A., Zoppini, G., Bonora, E., Barbieri, E. and Byrne, Christopher D. (2014) Association of nonalcoholic fatty liver disease with QTc interval in patients with type 2 diabetes. Nutrition, Metabolism and Cardiovascular Diseases, 24 (6), 663-669. (doi:10.1016/j.numecd.2014.01.005). (PMID:24594085)

Record type: Article

Abstract

Background and aims: the relationship between nonalcoholic fatty liver disease (NAFLD) and prolonged heart rate-corrected QT (QTc) interval, a risk factor for ventricular arrhythmias and sudden cardiac death, is currently unknown. We therefore examined the relationship between NAFLD and QTc interval in patients with type 2 diabetes.

Methods and results: we studied a random sample of 400 outpatients with type 2 diabetes. Computerized electrocardiograms were performed for analysis and quantification of QTc interval. NAFLD was diagnosed by ultrasonographic detection of hepatic steatosis in the absence of other liver diseases. Mean QTc interval and the proportion of those with increased QTc interval (defined as either QTc interval above the median, i.e. ?416 ms, or QTc interval >440 ms) increased steadily with the presence and ultrasonographic severity of NAFLD. NAFLD was associated with increased QTc interval (odds ratio [OR] 2.16, 95% CI 1.4–3.4, p < 0.001). Adjustments for age, sex, smoking, alcohol consumption, BMI, hypertension, electrocardiographic left ventricular hypertrophy, diabetes-related variables and comorbid conditions did not attenuate the association between NAFLD and increased QTc interval (adjusted-OR 2.26, 95% CI 1.4–3.7, p < 0.001). Of note, the exclusion of those with established coronary heart disease or peripheral artery disease from analysis did not appreciably weaken this association.

Conclusion: this is the first study to demonstrate that the presence and severity of NAFLD on ultrasound is strongly associated with increased QTc interval in patients with type 2 diabetes even after adjusting for multiple established risk factors and potential confounders

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Published date: June 2014
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 365289
URI: http://eprints.soton.ac.uk/id/eprint/365289
ISSN: 1590-3729
PURE UUID: 3541aefe-cfda-4918-89eb-02b58612d870
ORCID for Christopher D. Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 30 May 2014 14:38
Last modified: 15 Mar 2024 03:02

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Contributors

Author: G. Targher
Author: F. Valbusa
Author: S. Bonapace
Author: L. Bertolini
Author: L. Zenari
Author: I. Pichiri
Author: A. Mantovani
Author: G. Zoppini
Author: E. Bonora
Author: E. Barbieri

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