PMID- 30195089 OWN - NLM STAT- MEDLINE DCOM- 20190305 LR - 20190305 IS - 1878-1780 (Electronic) IS - 1262-3636 (Linking) VI - 44 IP - 6 DP - 2018 Dec TI - Association between decreasing estimated glomerular filtration rate and risk of cardiac conduction defects in patients with type 2 diabetes. PG - 473-481 LID - S1262-3636(18)30165-4 [pii] LID - 10.1016/j.diabet.2018.08.007 [doi] AB - AIM: We aimed to assess the association between decreasing estimated glomerular filtration rate (eGFR) or abnormal albuminuria and the risk of certain cardiac conduction defects in patients with type 2 diabetes mellitus (T2DM). METHODS: We examined a hospital-based sample of 923 patients with T2DM discharged from our Division of Endocrinology over the years 2007-2014. Standard electrocardiograms (ECGs) were performed in all patients. eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, whilst albuminuria was measured by an immuno-nephelometric method on morning spot urine samples. RESULTS: A total of 253 (27.4%) patients had some type of cardiac conduction defects on standard ECGs (defined as at least one heart block among first-degree atrioventricular block, second-degree block, third-degree block, left bundle branch block, right bundle branch block, left anterior hemi-block or left posterior hemi-block). Prevalence of patients with eGFR(CKD-EPI) < 30 mL/min/1.73 m(2), eGFR(CKD-EPI) 59-30 mL/min/1.73 m(2) or abnormal albuminuria (i.e. urinary albumin-to-creatinine ratio >/= 30 mg/g) were 7.0%, 29.4% and 41.3%, respectively. After adjustment for known cardiovascular risk factors, diabetes-related variables and potential confounders, there was a significant, graded association between decreasing eGFR values and risk of any cardiac conduction defects [adjusted-odds ratios of 2.05 (95% CI: 1.2-3.5), 2.85 (95% CI: 1.6-5.1) and 3.62 (95% CI: 1.6-8.1) for eGFR(CKD-EPI) 89-60, eGFR(CKD-EPI) 59-30 and eGFR(CKD-EPI) < 30 mL/min/1.73 m(2), respectively]. Conversely, abnormal albuminuria was not independently associated with an increased risk of any conduction defects (adjusted-odds ratio: 1.09, 95% CI: 0.7-1.6). CONCLUSION: Decreasing eGFR is independently associated with an increased risk of cardiac conduction defects in hospitalized patients with T2DM. CI - Copyright (c) 2018 Elsevier Masson SAS. All rights reserved. FAU - Mantovani, A AU - Mantovani A AD - Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy. FAU - Rigolon, R AU - Rigolon R AD - Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy. FAU - Turino, T AU - Turino T AD - Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy. FAU - Pichiri, I AU - Pichiri I AD - Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy. FAU - Falceri, A AU - Falceri A AD - Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy. FAU - Rossi, A AU - Rossi A AD - Section of Cardiology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy. FAU - Temporelli, P L AU - Temporelli PL AD - Division of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno (NO), Italy. FAU - Bonapace, S AU - Bonapace S AD - Division of Cardiology, ''Sacro Cuore-Don Calabria'' Hospital, Negrar (VR), Italy. FAU - Lippi, G AU - Lippi G AD - Section of Clinical Biochemistry, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy. FAU - Zoppini, G AU - Zoppini G AD - Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy. FAU - Bonora, E AU - Bonora E AD - Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy. FAU - Byrne, C D AU - Byrne CD AD - Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK; Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Tremona Road, Southampton, UK. FAU - Targher, G AU - Targher G AD - Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy. Electronic address: giovanni.targher@univr.it. LA - eng PT - Journal Article DEP - 20180905 PL - France TA - Diabetes Metab JT - Diabetes & metabolism JID - 9607599 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Cardiac Conduction System Disease/epidemiology/*physiopathology MH - Diabetes Mellitus, Type 2/epidemiology/*physiopathology MH - Electrocardiography MH - Female MH - Glomerular Filtration Rate/*physiology MH - Humans MH - Male MH - Middle Aged MH - Prevalence MH - Renal Insufficiency, Chronic/epidemiology/*physiopathology MH - Retrospective Studies MH - Risk Factors OTO - NOTNLM OT - Cardiac conduction defects OT - Chronic kidney disease OT - Diabetes OT - Kidney dysfunction EDAT- 2018/09/09 06:00 MHDA- 2019/03/06 06:00 CRDT- 2018/09/09 06:00 PHST- 2018/06/13 00:00 [received] PHST- 2018/08/04 00:00 [revised] PHST- 2018/08/27 00:00 [accepted] PHST- 2018/09/09 06:00 [pubmed] PHST- 2019/03/06 06:00 [medline] PHST- 2018/09/09 06:00 [entrez] AID - S1262-3636(18)30165-4 [pii] AID - 10.1016/j.diabet.2018.08.007 [doi] PST - ppublish SO - Diabetes Metab. 2018 Dec;44(6):473-481. doi: 10.1016/j.diabet.2018.08.007. Epub 2018 Sep 5.