The association of the metabolic syndrome with T-wave axis deviation in NHANES III

We sought to study the association between metabolic syndrome (MetS) and abnormal T-wave axis deviation.

A representative sample of the adult U.S. population, 3810 individuals 40 years of age or older, was categorized as having metabolic syndrome and not having the syndrome as defined by Adult Treatment Panel III. T-wave axis deviation was measured from the standard 12-lead electrocardiogram.

The odds of having abnormal T-wave axis deviation was calculated for those with metabolic syndrome versus those without after multivariable adjustment for age, race, daily alcohol consumption, body mass index categories, left ventricular hypertrophy, and heart rate. In multivariable weighted regression analysis, the odds were 2.03 times greater in those persons with MetS compared to those without (odds ratio, 1.79; 95% confidence interval, 1.04-3.11). The population-attributable risk percentage of abnormal T-wave axis deviation associated with MetS was 23.94%. Additionally, a graded relationship was observed between the number of MetS components and the odds ratio of abnormal T-wave axis (p trend < 0.01).

These data indicate that MetS is independently associated with an abnormal T-wave axis shift. This study calls for careful electrocardiographic monitoring among persons with MetS for early detection of abnormal T-wave axis in clinical practice to prevent severe and often fatal arrhythmias.