Dea H. Kofod, Søren Z. Diederichsen, Tobias Bomholt, Mads Ø. Andersen, Andreas Andersen, Ebba Mannheimer, Marianne Rix, Ylian S. Liem, Kristine Lindhard, Henrik P. Hansen, Casper Rydahl, Morten Lindhardt, Julie Brøsen, Kristine Schandorff, Theis Lange, Kirsten Nørgaard, Thomas P. Almdal, Jesper H. Svendsen, Bo Feldt-Rasmussen, Mads Hornum
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We employed implantable cardiac monitors for continuous heart rhythm monitoring in combination with periodic use of continuous glucose monitoring. Logistic-regression-type linear mixed models were used to examine associations between arrhythmias and glycaemic measures.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>During 18 months of follow-up, clinically significant arrhythmias (bradyarrhythmia and ventricular tachycardia) were identified in 12 (34%) participants with diabetes and 11 (31%) without diabetes. Atrial fibrillation was detected in 13 (37%) participants with diabetes and 14 (40%) without, while other supraventricular tachycardia was detected in seven (20%) and 11 (31%) participants with and without diabetes, respectively. Hypoglycaemia (sensor glucose <3.9 mmol/l) was observed in 27 (77%) participants with diabetes and 32 (91%) without diabetes. Compared with euglycaemia, hypoglycaemia was associated with an increased rate of arrhythmias among participants without diabetes (incidence rate ratio [IRR] 3.13 [95% CI 1.49, 6.55]), while hyperglycaemia (sensor glucose >10.0 mmol/l) was associated with a decreased rate of arrhythmias among participants with diabetes (IRR 0.58 [95% CI 0.37, 0.92]). Glycaemic variability showed no association with arrhythmias regardless of the presence of diabetes.</p><h3 data-test=\"abstract-sub-heading\">Conclusions/interpretation</h3><p>Arrhythmias and hypoglycaemia were common in those undergoing haemodialysis regardless of diabetes status. 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引用次数: 0
摘要
目的/假设我们的目的是检查接受血液透析的糖尿病患者和非糖尿病患者的心律失常和低血糖，并研究心律失常与低血糖、高血糖和血糖变异性之间的关系。方法本前瞻性多中心队列研究纳入了70例维持性血液透析患者（35例糖尿病患者和35例非糖尿病患者）。我们采用植入式心脏监护仪进行连续心律监测，并结合定期连续血糖监测。采用logistic回归型线性混合模型检验心律失常与血糖指标之间的关系。结果在18个月的随访中，12名糖尿病患者（34%）和11名非糖尿病患者（31%）发现有临床意义的心律失常（慢速性心律失常和室性心动过速）。13例（37%）糖尿病患者和14例（40%）非糖尿病患者检测到房颤，而其他室上性心动过速分别在7例（20%）和11例（31%）糖尿病和非糖尿病患者中检测到。在27名（77%）糖尿病患者和32名（91%）非糖尿病患者中观察到低血糖（传感器血糖3.9 mmol/l）。与高血糖相比，低血糖与非糖尿病患者心律失常发生率增加相关（发病率比[IRR] 3.13 [95% CI 1.49, 6.55]），而高血糖（传感器血糖>；10.0 mmol/l）与糖尿病患者心律失常发生率降低相关（IRR 0.58 [95% CI 0.37, 0.92]）。无论是否患有糖尿病，血糖变异性均与心律失常无关。结论/解释：无论是否患有糖尿病，接受血液透析的患者普遍存在心律失常和低血糖。我们的数据表明心律失常和血糖水平在糖尿病患者和非糖尿病患者之间存在时间关系。临床试验网站：NCT04841304。图形抽象
Cardiac arrhythmia and hypoglycaemia among individuals with and without diabetes receiving haemodialysis (the CADDY study): a Danish multicentre cohort study
Aims/hypothesis
We aimed to examine arrhythmias and hypoglycaemia among individuals with and without diabetes who are receiving haemodialysis and to investigate the association between arrhythmias and hypoglycaemia, hyperglycaemia and glycaemic variability.
Methods
This prospective multicentre cohort study included 70 participants on maintenance haemodialysis (35 with diabetes and 35 without diabetes). We employed implantable cardiac monitors for continuous heart rhythm monitoring in combination with periodic use of continuous glucose monitoring. Logistic-regression-type linear mixed models were used to examine associations between arrhythmias and glycaemic measures.
Results
During 18 months of follow-up, clinically significant arrhythmias (bradyarrhythmia and ventricular tachycardia) were identified in 12 (34%) participants with diabetes and 11 (31%) without diabetes. Atrial fibrillation was detected in 13 (37%) participants with diabetes and 14 (40%) without, while other supraventricular tachycardia was detected in seven (20%) and 11 (31%) participants with and without diabetes, respectively. Hypoglycaemia (sensor glucose <3.9 mmol/l) was observed in 27 (77%) participants with diabetes and 32 (91%) without diabetes. Compared with euglycaemia, hypoglycaemia was associated with an increased rate of arrhythmias among participants without diabetes (incidence rate ratio [IRR] 3.13 [95% CI 1.49, 6.55]), while hyperglycaemia (sensor glucose >10.0 mmol/l) was associated with a decreased rate of arrhythmias among participants with diabetes (IRR 0.58 [95% CI 0.37, 0.92]). Glycaemic variability showed no association with arrhythmias regardless of the presence of diabetes.
Conclusions/interpretation
Arrhythmias and hypoglycaemia were common in those undergoing haemodialysis regardless of diabetes status. Our data suggest a temporal relationship between arrhythmias and glucose level in both individuals with and without diabetes.
期刊介绍：
Diabetologia, the authoritative journal dedicated to diabetes research, holds high visibility through society membership, libraries, and social media. As the official journal of the European Association for the Study of Diabetes, it is ranked in the top quartile of the 2019 JCR Impact Factors in the Endocrinology & Metabolism category. The journal boasts dedicated and expert editorial teams committed to supporting authors throughout the peer review process.
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