Abstract
BackgroundTo assess the roles of diabetic microvascular disease and modifiable risk factors and their combination in the development of arrhythmias.MethodsWe included participants with type 2 diabetes (T2D) who were free of arrhythmias during recruitment in the UK Biobank study. The associations of microvascular disease states (defined by the presence of retinopathy, peripheral neuropathy or chronic kidney disease), four modifiable arrhythmic risk factors (body mass index, smoking, systolic blood pressure and glycosylated haemoglobin) and their joint associations with incident arrhythmias were examined.ResultsAmong the 25 632 participants with T2D, 1705 (20.1%) of the 8482 with microvascular disease and 2017 (11.8%) of the 17 150 without microvascular disease developed arrhythmias during a median follow-up of 12.3 years. Having any of the three microvascular diseases was associated with a 48% increase in the hazard of developing arrhythmias. Incorporating microvascular disease states into a model alongside 11 traditional risk factors significantly enhanced arrhythmia prediction. Furthermore, individuals with microvascular disease who had optimal levels of zero to one, two, three or four arrhythmic risk factors showed an HR of 2.05 (95% CI 1.85, 2.27), 1.67 (95% CI 1.53, 1.83), 1.35 (95% CI 1.22, 1.50) and 0.91 (95% CI 0.73, 1.13), respectively, compared with those without microvascular disease.ConclusionsAlthough microvascular disease, a non-traditional risk factor, was associated with incident arrhythmias in individuals with T2D, having optimal levels of risk factors may mitigate this risk.
Funder
National Natural Science Foundation of China
Guangzhou Science and Technology Project
the Shenzhen Science and Technology Innovation Committee
Open Project of the Guangdong Provincial Key Laboratory of Tropical Disease Research
Chinese Postdoctoral Science Foundation
the SUSTech Presidential Postdoctoral Fellowship
the R&D project of Pazhou Lab
Guangdong Basic and Applied Basic Research Foundation
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