Key result
Diabetes mellitus was associated with a more than three-fold higher likelihood of having fragmented QRS on electrocardiography compared to subjects without diabetes.
Why the study?
Fragmented QRS predicts adverse cardiac events, but its relationship with diabetes mellitus and metabolic syndrome in Japanese patients required investigation.
Is diabetes mellitus associated with a higher prevalence of fragmented QRS on electrocardiography compared to metabolic syndrome or control subjects?
Cross-Sectional (n=702)
Single-blind
No
Is diabetes mellitus associated with a higher prevalence of fragmented QRS on electrocardiography compared to metabolic syndrome or control subjects?
Diabetes mellitus is a significant determinant for the presence of fragmented QRS, an electrocardiographic marker of myocardial fibrosis, independent of metabolic syndrome.
Answers are grounded in this paper and cite their sources.
DM patients exhibit higher fQRS prevalence independent of MetS; supports fibrosis association but leaves clinical utility open pending outcomes data.
Background Fragmented QRS (fQRS) on electrocardiography is a marker of myocardial fibrosis and myocardial scar formation. fQRS has been reported as a reliable predictor of adverse cardiac events in several populations. We investigated the relationship of fQRS with diabetes mellitus (DM) and metabolic syndrome (MetS) in Japanese patients. Material and methods Our study enrolled a total of 702 subjects (435 without DM and 267 with type 2 DM) who had a routine health checkup at the Hokuriku Health Service Association (Toyama, Japan) in October 2014. Based on MetS and DM status, participants were categorized into one of the following four groups: DM+ MetS + (157 subjects); DM+ MetS - (110 subjects); DM- MetS + (82 subjects); and DM- MetS- (353 subjects). fQRS was assessed using the results of electrocardiography. Results The prevalence of fQRS was statistically higher in patients with DM+MetS+ (36%) and DM+MetS- (36%), than those with DM-MetS+ (18%) or DM-MetS- (9%) (p < 0.001). Significant differences were observed between the fQRS(+) and fQRS(-) groups for age, gender, waist circumference (WC), heart rate, hypertension, HbA1c, TC, MetS, and DM. The area under the receiver-operating curve for traditional risk factors and DM was 0.72 (p=0.0021, 95% confidence interval [CI]: 0.68-0.77), and for traditional risk factors and MetS it was 0.69 (p=0.1478, 95% CI: 0.64-0.73). Patients with DM had more than three-fold higher likelihood of showing fQRS (odds ratio, 3.41; 95% CI, 2.25-5.22; p<0.0001) compared to the reference group without DM, after adjusting for age, gender, dyslipidemia, hypertension, and WC. Conclusion fQRS was observed more frequently in DM than in MetS and control subjects. DM was the most significant determinant for fQRS among MetS and other traditional metabolic risk factors in the general Japanese population.
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Yagi et al. (2020) conducted a cross-sectional in Diabetes mellitus and metabolic syndrome (n=702). Diabetes mellitus vs. Subjects without diabetes mellitus was evaluated on Presence of fragmented QRS (fQRS) on electrocardiography (OR 3.41, 95% CI 2.25-5.22, p=<0.0001). Diabetes mellitus was associated with a more than three-fold higher likelihood of having fragmented QRS on electrocardiography compared to subjects without diabetes.
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