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Erschienen in: Diabetologia 8/2015

01.08.2015 | Article

Inverse association between fasting plasma glucose and risk of ventricular arrhythmias

verfasst von: Francesco Zaccardi, David R. Webb, Sudhir Kurl, Kamlesh Khunti, Melanie J. Davies, Jari A. Laukkanen

Erschienen in: Diabetologia | Ausgabe 8/2015

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Abstract

Aims/hypothesis

In nondiabetic individuals, low values of fasting plasma glucose (FPG) have been associated with an increased risk of cardiovascular events. Identification of the potential mechanisms behind this association could help to elucidate the relationship between glycaemia and cardiovascular disease. We aimed to determine the association between FPG and ventricular arrhythmias.

Methods

FPG and other cardiometabolic risk factors were measured in a population-based cohort of 2,482 men without a known history of type 2 diabetes mellitus at baseline. Associations between FPG levels and incident cases of ventricular arrhythmias (ventricular tachycardia or fibrillation events ascertained using the National Hospital Discharge Register) were estimated using Cox regression analysis adjusted for potential confounders.

Results

During a median follow-up of 23.3 (interquartile range 18.5–25.3) years, 74 (2.9%) incident events were recorded. In a multivariable analysis adjusted for age, systolic BP, smoking status, LDL- and HDL-cholesterol, and C-reactive protein, the HR for ventricular arrhythmia per 1 mmol/l higher baseline FPG was 0.58 (95% CI 0.34, 0.98); this estimate did not materially change after further adjustment for BMI, alcohol consumption, triacylglycerols and history of ischaemic heart disease (0.50 [95% CI 0.28, 0.89]).

Conclusions/interpretation

In this nondiabetic male population, FPG was inversely associated with incident risk of ventricular arrhythmias. While our results could help clarify the relationship between low glucose levels and cardiovascular risk, further studies are required to confirm these findings in other populations.
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Literatur
1.
Zurück zum Zitat Emerging Risk Factors Collaboration, Di Angelantonio E, Gao P et al (2014) Glycated hemoglobin measurement and prediction of cardiovascular disease. JAMA 311:1225–1233CrossRef Emerging Risk Factors Collaboration, Di Angelantonio E, Gao P et al (2014) Glycated hemoglobin measurement and prediction of cardiovascular disease. JAMA 311:1225–1233CrossRef
2.
Zurück zum Zitat Emerging Risk Factors Collaboration, Seshasai SR, Kaptoge S et al (2011) Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med 364:829–841CrossRef Emerging Risk Factors Collaboration, Seshasai SR, Kaptoge S et al (2011) Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med 364:829–841CrossRef
3.
Zurück zum Zitat Emerging Risk Factors Collaboration, Sarwar N, Gao P et al (2010) Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 375:2215–2222CrossRef Emerging Risk Factors Collaboration, Sarwar N, Gao P et al (2010) Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 375:2215–2222CrossRef
4.
Zurück zum Zitat DECODE Study Group, European Diabetes Epidemiology Group (2003) Is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular diseases? Diabetes Care 26:688–696CrossRef DECODE Study Group, European Diabetes Epidemiology Group (2003) Is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular diseases? Diabetes Care 26:688–696CrossRef
5.
Zurück zum Zitat Wei M, Gibbons LW, Mitchell TL, Kampert JB, Stern MP, Blair SN (2000) Low fasting plasma glucose level as a predictor of cardiovascular disease and all-cause mortality. Circulation 101:2047–2052PubMedCrossRef Wei M, Gibbons LW, Mitchell TL, Kampert JB, Stern MP, Blair SN (2000) Low fasting plasma glucose level as a predictor of cardiovascular disease and all-cause mortality. Circulation 101:2047–2052PubMedCrossRef
6.
Zurück zum Zitat Wändell PE, Theobald H (2007) The association between low fasting blood glucose value and mortality. Curr Diabetes Rev 3:274–279PubMedCrossRef Wändell PE, Theobald H (2007) The association between low fasting blood glucose value and mortality. Curr Diabetes Rev 3:274–279PubMedCrossRef
7.
Zurück zum Zitat Zipes DP, Camm AJ, Borggrefe M et al (2006) ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 27:2099–2140PubMedCrossRef Zipes DP, Camm AJ, Borggrefe M et al (2006) ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 27:2099–2140PubMedCrossRef
8.
Zurück zum Zitat Eckert B, Agardh CD (1998) Hypoglycaemia leads to an increased QT interval in normal men. Clin Physiol 18:570–575PubMedCrossRef Eckert B, Agardh CD (1998) Hypoglycaemia leads to an increased QT interval in normal men. Clin Physiol 18:570–575PubMedCrossRef
9.
Zurück zum Zitat Chow E, Bernjak A, Williams S et al (2014) Risk of cardiac arrhythmias during hypoglycemia in patients with type 2 diabetes and cardiovascular risk. Diabetes 63:1738–1747PubMedCrossRef Chow E, Bernjak A, Williams S et al (2014) Risk of cardiac arrhythmias during hypoglycemia in patients with type 2 diabetes and cardiovascular risk. Diabetes 63:1738–1747PubMedCrossRef
10.
Zurück zum Zitat Nordin C (2010) The case for hypoglycaemia as a proarrhythmic event: basic and clinical evidence. Diabetologia 53:1552–1561PubMedCrossRef Nordin C (2010) The case for hypoglycaemia as a proarrhythmic event: basic and clinical evidence. Diabetologia 53:1552–1561PubMedCrossRef
11.
Zurück zum Zitat Skyler JS, Bergenstal R, Bonow RO et al (2009) Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the ADA and a Scientific Statement of the ACC Foundation and the AHA. J Am Coll Cardiol 53:298–304PubMedCrossRef Skyler JS, Bergenstal R, Bonow RO et al (2009) Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the ADA and a Scientific Statement of the ACC Foundation and the AHA. J Am Coll Cardiol 53:298–304PubMedCrossRef
12.
Zurück zum Zitat Salonen JT (1988) Is there a continuing need for longitudinal epidemiologic research? The Kuopio Ischaemic Heart Disease Risk Factor Study. Ann Clin Res 20:46–50PubMed Salonen JT (1988) Is there a continuing need for longitudinal epidemiologic research? The Kuopio Ischaemic Heart Disease Risk Factor Study. Ann Clin Res 20:46–50PubMed
13.
Zurück zum Zitat von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61:344–349CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61:344–349CrossRef
14.
Zurück zum Zitat Lakka TA, Venäläinen JM, Rauramaa R, Salonen R, Tuomilehto J, Salonen JT (1994) Relation of leisure-time physical activity and cardiorespiratory fitness to the risk of acute myocardial infarction. N Engl J Med 330:1549–1554PubMedCrossRef Lakka TA, Venäläinen JM, Rauramaa R, Salonen R, Tuomilehto J, Salonen JT (1994) Relation of leisure-time physical activity and cardiorespiratory fitness to the risk of acute myocardial infarction. N Engl J Med 330:1549–1554PubMedCrossRef
15.
Zurück zum Zitat Laukkanen JA, Mäkikallio TH, Rauramaa R, Kiviniemi V, Ronkainen K, Kurl S (2010) Cardiorespiratory fitness is related to the risk of sudden cardiac death: a population-based follow-up study. J Am Coll Cardiol 56:1476–1483PubMedCrossRef Laukkanen JA, Mäkikallio TH, Rauramaa R, Kiviniemi V, Ronkainen K, Kurl S (2010) Cardiorespiratory fitness is related to the risk of sudden cardiac death: a population-based follow-up study. J Am Coll Cardiol 56:1476–1483PubMedCrossRef
16.
Zurück zum Zitat Easton DF, Peto J, Babiker AG (1991) Floating absolute risk: an alternative to relative risk in survival and case-control analysis avoiding an arbitrary reference group. Stat Med 10:1025–1035PubMedCrossRef Easton DF, Peto J, Babiker AG (1991) Floating absolute risk: an alternative to relative risk in survival and case-control analysis avoiding an arbitrary reference group. Stat Med 10:1025–1035PubMedCrossRef
17.
Zurück zum Zitat Coutinho M, Gerstein HC, Wang Y, Yusuf S (1999) The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care 22:233–240PubMedCrossRef Coutinho M, Gerstein HC, Wang Y, Yusuf S (1999) The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care 22:233–240PubMedCrossRef
18.
Zurück zum Zitat Balkau B, Bertrais S, Ducimetiere P, Eschwege E (1999) Is there a glycemic threshold for mortality risk? Diabetes Care 22:696–699PubMedCrossRef Balkau B, Bertrais S, Ducimetiere P, Eschwege E (1999) Is there a glycemic threshold for mortality risk? Diabetes Care 22:696–699PubMedCrossRef
19.
Zurück zum Zitat Levitan EB, Song Y, Ford ES, Liu S (2004) Is nondiabetic hyperglycemia a risk factor for cardiovascular disease? A meta-analysis of prospective studies. Arch Intern Med 164:2147–2155PubMedCrossRef Levitan EB, Song Y, Ford ES, Liu S (2004) Is nondiabetic hyperglycemia a risk factor for cardiovascular disease? A meta-analysis of prospective studies. Arch Intern Med 164:2147–2155PubMedCrossRef
20.
Zurück zum Zitat Rutter MK (2012) Low HbA1c and mortality: causation and confounding. Diabetologia 55:2307–2311PubMedCrossRef Rutter MK (2012) Low HbA1c and mortality: causation and confounding. Diabetologia 55:2307–2311PubMedCrossRef
21.
Zurück zum Zitat Zhang Y, Han H, Wang J, Wang H, Yang B, Wang Z (2003) Impairment of human ether-à-go-go-related gene (HERG) K+ channel function by hypoglycemia and hyperglycemia. Similar phenotypes but different mechanisms. J Biol Chem 278:10417–10426PubMedCrossRef Zhang Y, Han H, Wang J, Wang H, Yang B, Wang Z (2003) Impairment of human ether-à-go-go-related gene (HERG) K+ channel function by hypoglycemia and hyperglycemia. Similar phenotypes but different mechanisms. J Biol Chem 278:10417–10426PubMedCrossRef
22.
23.
Zurück zum Zitat Thygesen K, Alpert JS, Jaffe AS et al (2012) ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. Third universal definition of myocardial infarction. Eur Heart J 33:2551–2567PubMedCrossRef Thygesen K, Alpert JS, Jaffe AS et al (2012) ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. Third universal definition of myocardial infarction. Eur Heart J 33:2551–2567PubMedCrossRef
25.
Zurück zum Zitat Kleppe M, Levine RL (2014) Tumor heterogeneity confounds and illuminates: assessing the implications. Nat Med 20:342–344PubMedCrossRef Kleppe M, Levine RL (2014) Tumor heterogeneity confounds and illuminates: assessing the implications. Nat Med 20:342–344PubMedCrossRef
27.
Zurück zum Zitat ORIGIN Trial Investigators, Mellbin LG, Rydén L, Riddle MC et al (2013) Does hypoglycaemia increase the risk of cardiovascular events? A report from the ORIGIN trial. Eur Heart J 34:3137–3144CrossRef ORIGIN Trial Investigators, Mellbin LG, Rydén L, Riddle MC et al (2013) Does hypoglycaemia increase the risk of cardiovascular events? A report from the ORIGIN trial. Eur Heart J 34:3137–3144CrossRef
29.
Zurück zum Zitat Seaquist ER, Anderson J, Childs B et al (2013) Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care 36:1384–1395PubMedCentralPubMedCrossRef Seaquist ER, Anderson J, Childs B et al (2013) Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care 36:1384–1395PubMedCentralPubMedCrossRef
30.
Zurück zum Zitat Laukkanen JA, Mäkikallio TH, Ronkainen K, Karppi J, Kurl S (2013) Impaired fasting plasma glucose and type 2 diabetes are related to the risk of out-of-hospital sudden cardiac death and all-cause mortality. Diabetes Care 36:1166–1171PubMedCentralPubMedCrossRef Laukkanen JA, Mäkikallio TH, Ronkainen K, Karppi J, Kurl S (2013) Impaired fasting plasma glucose and type 2 diabetes are related to the risk of out-of-hospital sudden cardiac death and all-cause mortality. Diabetes Care 36:1166–1171PubMedCentralPubMedCrossRef
31.
Zurück zum Zitat John RM, Tedrow UB, Koplan BA et al (2012) Ventricular arrhythmias and sudden cardiac death. Lancet 380:1520–1529PubMedCrossRef John RM, Tedrow UB, Koplan BA et al (2012) Ventricular arrhythmias and sudden cardiac death. Lancet 380:1520–1529PubMedCrossRef
Metadaten
Titel
Inverse association between fasting plasma glucose and risk of ventricular arrhythmias
verfasst von
Francesco Zaccardi
David R. Webb
Sudhir Kurl
Kamlesh Khunti
Melanie J. Davies
Jari A. Laukkanen
Publikationsdatum
01.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Diabetologia / Ausgabe 8/2015
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-015-3646-0

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