Dynamic evaluation of serum atherogenic factors as a predictor of QT interval prolongation in patients with type 2 diabetes mellitus.

OBJECTIVE

To investigate the correlation between dynamic changes in serum atherogenic factors and QT interval prolongation in type 2 diabetes mellitus (T2DM) patients, and evaluate its clinical application value.

METHODS

A single-center retrospective analysis was conducted on 613 T2DM patients, who met the 2011 American Diabetes Association criteria, at Nantong Hospital to Nanjing University of Chinese Medicine. Clinical data, atherogenic lipid profiles, inflammatory factors, and endothelial function indicators were collected. All patients underwent 12-lead electrocardiography to measure corrected QT interval (QTc) at baseline and after 12-month follow-up. Repeated measures ANOVA was used to compare indicator dynamics between patients with new-onset QT prolongation and non-prolongation groups, followed by multivariate logistic regression and ROC curve analyses.

RESULTS

During follow-up, 32 (5.2%) patients developed QT prolongation. Baseline diabetes duration, HbA1c, atherogenic lipid indices (e.g., TG/HDL-C ratio), hs-CRP, IL-6, ET-1 and vWF were significantly higher, while HDL-C and NO were lower in the prolongation group (all P<0.05). These factors correlated with QTc. Multivariate regression identified TG/HDL-C ratio, hs-CRP, ET-1 and IL-6 as independent risk factors, with TG/HDL-C ratio showing the highest risk. Combined detection of these indicators yielded superior predictive value for QT prolongation over single indicators (P<0.05).

CONCLUSION

Abnormal atherogenic lipids, inflammatory factors and endothelial markers correlate with QT interval prolongation in T2DM. Combined detection of TG/HDL-C ratio, hs-CRP, IL-6 and ET-1 enhances the predictive efficacy for QT prolongation.