Microvascular disease, modifiable risk factor profiles and incident arrhythmias in type 2 diabetes

医学 风险因素 2型糖尿病 内科学 疾病 糖尿病 心脏病学 体质指数 肾脏疾病 危险系数 内分泌学 置信区间
作者
Guo‐Chong Chen,Daniel Nyarko Hukportie,Wei-Dong Fan,Jie-Qiong Lyu,Haipeng Wang,Li‐Qiang Qin,Xianbo Wu,Fu‐Rong Li
出处
期刊:Heart [BMJ]
卷期号:110 (11): 776-782 被引量:1
标识
DOI:10.1136/heartjnl-2023-323527
摘要

Background To assess the roles of diabetic microvascular disease and modifiable risk factors and their combination in the development of arrhythmias. Methods We included participants with type 2 diabetes (T2D) who were free of arrhythmias during recruitment in the UK Biobank study. The associations of microvascular disease states (defined by the presence of retinopathy, peripheral neuropathy or chronic kidney disease), four modifiable arrhythmic risk factors (body mass index, smoking, systolic blood pressure and glycosylated haemoglobin) and their joint associations with incident arrhythmias were examined. Results Among the 25 632 participants with T2D, 1705 (20.1%) of the 8482 with microvascular disease and 2017 (11.8%) of the 17 150 without microvascular disease developed arrhythmias during a median follow-up of 12.3 years. Having any of the three microvascular diseases was associated with a 48% increase in the hazard of developing arrhythmias. Incorporating microvascular disease states into a model alongside 11 traditional risk factors significantly enhanced arrhythmia prediction. Furthermore, individuals with microvascular disease who had optimal levels of zero to one, two, three or four arrhythmic risk factors showed an HR of 2.05 (95% CI 1.85, 2.27), 1.67 (95% CI 1.53, 1.83), 1.35 (95% CI 1.22, 1.50) and 0.91 (95% CI 0.73, 1.13), respectively, compared with those without microvascular disease. Conclusions Although microvascular disease, a non-traditional risk factor, was associated with incident arrhythmias in individuals with T2D, having optimal levels of risk factors may mitigate this risk.
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