Key result
Prediabetes is linked to prolonged ventricular repolarization, including a ~17 ms longer Tp-e interval versus controls.
Why the study?
Although diabetes mellitus is linked to ventricular repolarization changes on ECG, few studies have examined the connection between prediabetes mellitus and these ventricular repolarization characteristics.
Does prediabetes mellitus alter ventricular repolarization markers on electrocardiography compared to healthy controls?
Case-Control (n=158)
Double-anonymized
No
Does prediabetes mellitus alter ventricular repolarization markers on electrocardiography compared to healthy controls?
Absolute Event Rate: 91.82% vs 74.62%
p-value: p=<0.001
Prediabetes mellitus is associated with prolonged ventricular repolarization markers on ECG, suggesting an early predisposition to ventricular arrhythmias before the onset of overt diabetes.
May signal early arrhythmic vulnerability in prediabetes; leaves open prospective outcome validation before clinical adoption.
Background: The blood glucose levels in people with prediabetes mellitus (PDM) are regarded as too high to be normal but below the cutoff for diabetes mellitus (DM). Clinical indicators for PDM patients include impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and/or hemoglobin A1c (HbA1c) levels between 5.7 and 6.4% (39-47 mmol/mol). PDM has been shown to raises the risk of cardiovascular disease (CVD) and mortality. Meanwhile, death and morbidity can be predicted by the new ventricular repolarization features of the electrocardiogram (ECG). Several studies have analyzed the connection between DM and the ventricular repolarization characteristics of ECG; however, few studies have examined the connection between PDM and these ventricular repolarization characteristics. This study evaluated the ECG ventricular repolarization parameters in individuals with PDM. Methods: A retrospective case-control design was used. Randomly selected participants included 79 PDM patients (30 men, mean age: 39.7 ± 5.7 years) and 79 controls (30 men, mean age: 39.8 ± 5.2 years). ECG intervals analyzed were the distance from the beginning of the Q wave to the end of the T wave (QT), the distance between Q and S waves (QRS), the distance between the T wave's termination and point J (JT), and the distance between the peak and endpoint of the T wave (Tp-e), along with corrected and derived measures (corrected QT interval (QTc), the difference between the maximum and smallest QT intervals (QTd), corrected QTd (QTdc), corrected JT interval (JTc), Tp-e/QT, Tp-e/QTc, Tp-e/JT, Tp-e/JTc). Patient records were retrieved from the institution's database. Results: > 0.05 for each). Similarly, both groups had similar QT, QRS, and JT intervals. PDM patients had significantly greater heart rates (bpm), and QTc, QTd, QTdc, JTc, and Tp-e intervals (millisecond, ms) than the control group. The results were deemed significant when HbA1c levels were associated with every employed ECG measurement in our investigation. Conclusions: In our study, the HbA1c value was shown to be moderately positively correlated with the heart rate and QTc, QTd, QTdc, JTc, and Tp-e intervals, all of which were determined to be significant. Additionally, the HbA1c value showed a weak positive correlation with Tp-e/QT, Tp-e/JT ratios, which were statistically significant. This study showed that patients with PDM are prone to ventricular arrhythmia in the early period of the disorder.
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Memioğlu et al. (2025) conducted a case-control in Prediabetes mellitus (n=158). Prediabetes mellitus vs. Healthy controls was evaluated on Tp-e interval (ms) (p=<0.001). Prediabetes mellitus was associated with significantly prolonged ventricular repolarization markers, including a longer Tp-e interval (91.82 vs 74.62 ms) compared to healthy controls.
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