Correlation between metabolic control, serum electrolyte levels, duration of illness and QT interval length parameters in children with type 1 diabetes mellitus

摘要

BACKGROUND. Cardiac autonomic neuropathy (CAN) is a common complication of type 1 diabetes mellitus (T1DM) that can cause arrhythmia and increase mortality risk. Prolonged corrected-QT (QTc) and dispersion-QT (QTd) intervals can be used for early detection. Few studies have investigated relationships between metabolic control, serum electrolyte levels, duration of illness and CAN in T1DM children. OBJECTIVE. To investigate serum haemoglobin A1c (HbA1c) level, serum electrolyte levels, duration of illness and QTc and QTd interval parameters in T1DM children. METHODS. This cross-sectional study included T1DM patients up to 18 yearsof age at the Paediatric Outpatients Clinic, Dr. Soetomo Hospital, Surabaya, Indonesia, between January 2016 and July 2017. Serum HbA1c and sodium and potassium levels were analysed. QTc and QTd intervals were recorded from 12-lead electrocardiograms. RESULTS. Of the 40 patients, 70% were found to have poor metabolic control. Among patients with poor metabolic control, prolonged QTc and QTd intervals were observed in 21 (75.0%) and 16 (57.1%), respectively. Serum HbA1c levels were significantly correlated with QTc (p=0.001; r=0.541) and QTd interval lengths (p=0.018; r=0.373). Hypokalaemia was observed in 28 patients, with prolonged QTc and QTd intervals seen in 85% (n=17) and 55% (n=11), respectively. We found significant correlations between potassium level and QTc interval length (p0.05; r=0.556), but not between potassium level and QTd interval length. CONCLUSION. We suggest that prolonged QTc and QTd intervals could be predictive of a cardiovascular complication in T1DM in children.