| Background:The International Diabetes Federation has predicted that the number of individuals with diabetes will increase from 240 million in 2007 to 380 million in 2025,and will further increase to 439 million in 2030[1,2].Urbanization is associated with changes in lifestyle that lead to physical inactivity,an unhealthful diet,and obesity,all of which have been implicated as contributing factors in the development of diabetes [3].Retinopathy is the most common complication of diabetes.Furthermore,diabetic retinopathy(DR)is the most important cause of visual loss worldwide.At the same time,one of the other complications of diabetes is generalized atherosclerosis which can be presented as ischemic heart disease,cerebrovascular accident or peripheral vascular disease.Unfortunately,diabetes increases the risk of microvascular and macrovascular complications and premature death in the general population and results in a huge economic burden for society.Extensive studies have now shown that in diabetic patients without a history of clinical CVD,the presence of advanced stage of DR is associated with subclinical coronary artery disease [4,5] Diabetic atherosclerosis can be detected by measurement of internal carotid artery(CIMT)or plaque lesion.The Carotid artery atherosclerosis was used to predict of cardiovascular outcomes in diabetic patients[6].the easy applicability and the noninvasive nature of the electrocardiographic PR,QT,QTc interval make it suitable for using as a surrogate endpoint for the people with cardiovascular events[7,8].So the aim of our study was evaluation of relationship between electrocardiographic PR,QT,QTc interval and retinopathy?carotid artery atherosclerosis as three valuable noninvasive methods for early detection of micro and macrovascular complication of diabetes.Objective:To study the relations between PR,QT,QTc interval and diabetic retinopathy,carotid artery atherosclerosis,Then,to explore the role of PR,QT,QTc interval in the diagnosis of diabetic retinopathy and carotid artery atherosclerosis.Methods:In cases of retrospective study,the first part of a total of 812 hospitalized patients from June 2014 to March 2016 with 2-Diabetes Mellitus in Department of endocrinology and metabolism of our hospital,including 547 males and 265 females;the second part included 1249 patients,including 847 males and 402 females.The following information was obtained from the medical records: fasting blood glucose,Hemoglobin A1 c,triglyceride,total cholesterol,HDL,LDL,BU,Cr,UA,Cys-C,etc.In this study,a standard 12-lead ECG was measured by Japan photoelectric electrocardiogram machine;Diabetic retinopathy was measured by fundus photography;Common carotid intima-media thickness(CIMT)and Plaque was defined as the largest distance between the luminal intima interface and the medial adventitia interface that is located at 1 cm of the initiation of the common carotid artery that was measured by Doppler sonography devices.A two-tailed value of <0.05 was considered statistically significant.Data were analyzed using SPSS version 19.0.Results:1.1 They were selected and divided into two groups according to their fundus photography results: patients without diabetic retinopathy(NDR group,n=480),patients with diabetic retinopathy(DR group,n=332),DR group with Age,T2 MD Course,Height,weight,SBP,DBP,FPG,BUN,Cr,Cys-C,PR,QT,QTc interval was significantly greater than NDR group(P < 0.05).1.2 Logistic regression analysis showed that the independent correlation between PR and DR and that the risk of DR for T2 DM patients with PR>162ms is 1.775 time higher than those with PR?162ms(P < 0.05);T2DM patients with PR>200ms is 2.711 time higher than those with PR?200ms(P < 0.05).1.3 Logistic regression analysis showed that the independent correlation between QTc and DR and that the risk of DR for T2 DM patients with QTc>404ms is 1.732 time higher than those with QTc?404ms(P < 0.05);T2DM patients with QTc>440ms is 2.712 time higher than those with QTc?440ms(P < 0.05).1.4 Logistic regression analysis showed that did not find a significant correlation between QT interval and DR.2.1 They were selected and divided into two groups according to their B-mode ultrasonography results: patients without carotid artery atherosclerosis(NCAS group).(n=548),patients with carotid artery atherosclerosis(CAS group).(n=701),CAS group with Age,type 2 diabetes,SBP,LDL-c,BUN,Cr,Cys-C,PR,QT,QTc interval was significantly greater than NCAS group(P < 0.05).2.2 Spearman correlation analysis showed that weak correlation between PR,QT,QTc interval and CAS(r = 0.122?0.082?0.099,P<0.05).2.3 Logistic regression analysis of CAS with PR,QT,QTc interval showed that did not find a significant correlation between PR,QT,QTc interval and CAS(P > 0.05).Conclusion:Firstly,the group with the higher levels of electrocardiographic PR,QTc interval has a higher risk of DR among diabetic patients.So we may use electrocardiographic PR,QTc interval as a simple,available,and noninvasive method for screening of micro complications among diabetic patients.Secondly,about association of electrocardiographic PR,QTc interval and CAS we did not find a significant correlation.In a word,it is probably that microvascular complications correlated with Cardiac conduction dysfunction was more related than macrovascular complications among diabetic patients. |
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