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Exploring the link between atherosclerosis indicators and QT interval in type 2 diabetes: a retrospective

Shunsuke Kobayashi1, Mototsugu Nagao1, Izumi Fukuda2

  • 1Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.

Therapeutic Advances in Endocrinology and Metabolism
|May 25, 2026
PubMed

Insights

Vascular endothelial dysfunction (FMD) is linked to prolonged QT intervals in type 2 diabetes patients, especially those who are not obese. This finding aids in identifying individuals at higher risk for dangerous heart arrhythmias.

Area of Science:

  • Cardiology
  • Endocrinology
  • Vascular Medicine

Background:

  • Prolonged QT interval is a risk factor for life-threatening arrhythmias and sudden cardiac death.
  • Identifying clinical markers for myocardial repolarization abnormalities is crucial for risk stratification in type 2 diabetes patients.

Purpose of the Study:

  • To investigate the association between non-invasive atherosclerosis indicators and corrected QT (QTc) interval prolongation.
  • To assess the relationship between QTc interval and markers of vascular health in type 2 diabetes.

Main Methods:

  • Retrospective cross-sectional analysis of 96 type 2 diabetes patients.
  • QTc interval calculated using Bazett, Fridericia, and Framingham formulas.
  • Assessment of ankle-brachial index (ABI), cardio-ankle vascular index (CAVI), carotid intima-media thickness (IMT), and flow-mediated dilatation (FMD).

Main Results:

  • Flow-mediated dilatation (FMD) was negatively correlated with QTcB in univariate analyses (r = -0.28, p = 0.0054).
  • FMD was independently associated with QTcB in multivariable analyses (β = -1.95 ms per 1% increase; p = 0.021).
  • The association between FMD and QTc prolongation was more prominent in non-obese patients (BMI < 25 kg/m²).

Conclusions:

  • Vascular endothelial dysfunction, indicated by FMD, is independently associated with QTc prolongation in type 2 diabetes.
  • This association is particularly significant in non-obese individuals, suggesting a link to increased arrhythmia risk.
  • Findings highlight FMD as a potential marker for identifying high-risk patients with type 2 diabetes.
Abstract

Keywords:
atherosclerosiscorrected QT intervalflow-mediated dilatationtype 2 diabetes mellitus

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