2型糖尿病患者的心电图异常和肾功能损害:尼泊尔Dang地区一项基于医疗机构的横断面研究

IF 3.2 3区医学 Journal of Diabetes Investigation Pub Date : 2023-02-06 DOI:10.1111/jdi.13985

Mahesh Kumar Khanal, Pratiksha Bhandari, Raja Ram Dhungana, Yadav Gurung, Lal B. Rawal, Gyanendra Pandey, Madan Bhandari, Rijwan Bhuiyan, Surya Devkota, Maximilian de Courten, Barbora de Courten

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引用次数: 1

摘要

全球糖尿病负担正在大幅上升，心血管和肾脏疾病负担进一步增加。这些公共卫生问题在包括尼泊尔在内的低收入和中等收入国家非常普遍。然而，关于2型糖尿病患者的心脏和肾脏疾病的证据有限。我们确定了尼泊尔2型糖尿病患者的心电图(ECG)异常和肾功能损害状况。方法采用多阶段分层抽样技术，在尼泊尔图尔西普尔市开展横断面研究，招募2型糖尿病患者。采用世界卫生组织逐步监测法(WHO STEPS)问卷调查，静息心电图采集345例2型糖尿病患者资料。Logistic回归分析评估与心电图异常和肾功能损害相关的因素。结果研究显示，6.1%的参与者存在严重心电图异常(95%可信区间[CI] 3.8 ~ 8.6%)，这些异常与高血压(P = 0.01%)和低社会经济地位(P = 0.01)相关。主要和/或轻微心电图异常的比例为47.8% (95% CI 40.5-51%)，与年龄(比值比[or] 1.04, 95% CI 1.01-1.07)、高等教育(or 3.50, 95% CI 1.31-9.33)、失业(or 3.02, 95% CI 1.08-8.48)、体重指数(or 1.09, 95% CI 1.02-1.17)、2型糖尿病病程(or 2.42, 95% CI 1.19-4.93)显著相关。肾功能损害的比例为3.5% (95% CI 1.5-4.5%)，与年龄较大(OR 1.08, 95% CI 1.00-1.17)和高血压(OR 12.12, 95% CI 1.07-138.22)相关。结论2型糖尿病患者有显著比例的心电图异常和肾功能损害，并与高血压有显著相关性。因此，高血压管理和早期筛查对于预防2型糖尿病患者未来的心肾并发症至关重要。

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Electrocardiogram abnormalities and renal impairment in patients with type 2 diabetes mellitus: A healthcare facilities-based cross-sectional study in Dang district of Nepal

Aims/Introduction

The global burden of diabetes mellitus is rising substantially, with a further increase in cardiovascular and kidney disease burden. These public health problems are highly prevalent in low- and middle-income countries, including Nepal. However, there is limited evidence on cardiac and renal conditions among patients with type 2 diabetes mellitus. We determined the status of electrocardiogram (ECG) abnormalities and renal impairment among patients with type 2 diabetes mellitus in Nepal.

Methods

We carried out a cross-sectional study in Tulsipur Sub-Metropolitan City of Nepal using a multistage stratified sampling technique to recruit patients with type 2 diabetes mellitus. We used World Health Organization stepwise approach to surveillance (WHO STEPS) questionnaires and carried out resting ECG to collect data of 345 patients with type 2 diabetes mellitus. Logistic regression analysis assessed the factors associated with ECG abnormalities and renal impairment.

Results

The study showed that 6.1% of participants had major ECG abnormalities (95% confidence interval [CI] 3.8–8.6%), which were associated with hypertension (P = 0.01%) and low socioeconomic status (P = 0.01). The proportion of major and/or minor ECG abnormalities was 47.8% (95% CI 40.5–51%), and were significantly associated with age (odds ratio [OR] 1.04, 95% CI 1.01–1.07), higher education (OR 3.50, 95% CI 1.31–9.33), unemployment (OR 3.02, 95% CI 1.08–8.48), body mass index (OR 1.09, 95% CI 1.02–1.17) and duration of type 2 diabetes mellitus >5 years (OR 2.42, 95% CI 1.19–4.93). The proportion of renal impairment was 3.5% (95% CI 1.5–4.5%) which was associated with older age (OR 1.08, 95% CI 1.00–1.17) and hypertension (OR 12.12, 95% CI 1.07–138.22).

Conclusion

A significant proportion of patients with type 2 diabetes mellitus had ECG abnormalities and renal impairment, which were significantly associated with hypertension. Therefore, hypertension management and early screening are essential to prevent future cardiorenal complications among patients with type 2 diabetes mellitus.

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来源期刊

Journal of Diabetes Investigation Medicine-Internal Medicine

自引率

9.40%

发文量

218

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).