QT Interval prolongation is common in insulin resistance state obesity. Insulin-induced hyperpolarization might be involved in ventricular repolarization leading to QTc lengthening. Therefore, this study is designated to investigate the relationship between corrected QT interval (QTc) prolongation and insulin resistance in obese adult male subjects. Apparently healthy adult male subjects (n=100) aged between 18-35 years residing in Magway Township were recruited by simple random sampling method. Then all the eligible subjects were categorized into 2 groups: non-obese [body mass index (BMI) 18.5 to 24.9 kg/m2, n= 40] and obese group [BMI ≥ 30.0 kg/m2, n=60] by their anthropometric parameters. Serum fasting glucose was measured by glucose oxidase method. Serum insulin level was determined by Enzyme-Linked Immunosorbent Assay (ELISA). Insulin sensitivity was calculated by Homeostatic Model Assessment (HOMA-IR). The QT interval was measured by routine 12-lead ECG and corrected QT interval (QTc) was calculated according to Bazett’s formula. In the present study, insulin sensitivity (HOMA-IR) was higher in obese subjects (4.64±2.3) than that of non-obese subjects (2.5±0.89) (p< 0.001). There was significant positive correlation between QTc and HOMA-IR (r = 0.41, p< 0.001, n = 100) in this study. HOMA-IR >3.8 was considered as insulin resistance (IR) and QTc > 440ms was regarded as QTc interval prolongation. Insulin resistance was significantly associated with prolonged QTc interval in the study population (X2=7.3, p< 0.05, n=100). Risk of QTc interval prolongation was 3.4 times higher in subjects with IR (Odd ratio = 3.4; 95% confidence interval = 1.37 to 8.45). It was concluded that prolonged QTc interval is associated with insulin resistance state.
Guven A, Ozgen T, Gungor O, Aydin M and Baysal K.Association between the corrected QT Interval and carotid artery intimal-media thickness in obese children.J Clin Res Ped Endo 2010(1): 21-27.
Bazett HC. An analysis of the time relationships of electrocardiograms. Heart 1920;7:353-357.
Arslan E, Yininer O, Yavasoglul I, Ozcelik F, Kardesoglu E and Nalbant S. Effect of uncomplicated obesity on QT interval in young men.Pol Arch Med Wewn 2010; 120(6): 209-213.
Vlay SC, Mallis GI, Brown EJ, Cohn PF. Documented sudden cardiac death in prolonged QT syndrome. Arch Intern Med 1984;144: 833-835.
Giraldi FP, Manzonil G, Michailidis J, Scacchi M, Stramba-Badiale M and Cavagnini F. High prevalence of prolonged QT interval in obese hypogonadal males.Obesity 2011;19: 2015-2018.
Milovancev A, Stokic E, Popovic DS, Naglic DT, Rankov O.Body Weight Reduction and QTc Interval in Obesity.Adv Weigh Loss Manag Med Dev 2016;1:102. doi:10.4172/AWMD.1000102.
Dekker, J.M., Crow, R.S., Hannan, P.J., Schouten, E.G. and Folsom, A.R. Heart rate corrected QT interval prolongation predicts risk of coronary heart diseases in black and white middle-aged men and women. Journal of the American College of Cardiology 2004; 43(4): 565-636.
Straus, S.M.J.M., Kors, J.A., Bruin, M.L.D., van der Hoof, C.S., Hofman, A., Heeringa, J., Decker, J.W., Kingma, J.H., Sturkenboom, M.C.J.M., Stricker, B.H.C. and Witteman, J.C.M. Prolong QTc interval and risk of sudden cardiac death in a population of older adults. Journal of the American College of Cardiology 2006; 47(2): 362-369.
Festa A, D’Agostino R Jr, Rautaharju P, Mykkanen L, Haffner SM. Relation of systemic blood pressure, left ventricular mass, insulin sensitivity, and coronary artery disease to QT interval duration in nondiabetic and type 2 diabetic subjects. Am J Cardiol. 2000; 86(10):1117–22.
Yang X, Su J, Zhang X, Zhao L, Xu F, Wang X, Cheng X. The relationship between insulin sensitivity and heart rate- corrected QT interval in patients with type 2 diabetes. Diabetol Metab Syndr 2017; 9(69): 1-9.
Himsworth, H.P. Diabetes mellitus; its differentiation into insulin sensitive and insulin insensitive types. Lancet, 1936; 1:127-30.
Zierler K. Effect of insulin on membrane potential and potassium content of rat muscle. Am J Physiol 1959;197: 515–523.
Gastaldelli A, Emdin M, Conforti F, Camastra S and Ferrannini E. Insulin prolongs the QTc interval in humans. Am J Physiol Regul Integr Comp Physiol 2000; 279: 2022-2025.
Matthews, D.R., Hosker, J.P., Rudenski, A.S., Naylor, B.A., Treacher, D.F. and Turner, R.C. Homeostasis model assessment: insulin resistance and β cell function from fasting plasma glucose and insulin concentration in man. Diabetiologia 1985; 28, p. 412-9.
Qu HQ, Li Q, Rentfro AR, Fisher-Hoch SP, McCormick JB. The definition of insulin resistance using HOMA-IR for Americans of Mexican descent using machine learning. PloS one, 2011; 6(6).
Bogardus C, Lillioja S, Mott D, Reaven GR, Kashiwagi A and Foley JE. Relationship between obesity and maximal insulin-stimulated glucose uptake in vivo and in vitro in Pima Indians. J Clin Invest. 1984; 73(3):800-805.
Ferrannini E, Natali A, Bell P, Cavallo-Perin P, Lalic N and Mingrone G. Insulin resistance and hypersecretion in obesity. European Group for the Study of Insulin Resistance (EGIR). J Clin Invest. 1997;100(5):1166-1173.
Greco, A.V., Mingrone, G., Giancaterini, A., Manco, M., Morroni, M., Cinti, S., Granzotto, M., Vettor, R., Camastra, S. and Ferrannini, E. (2002) Insulin resistance in morbid obesity. Diabetes, 51, p. 144-51.
Camastra, S.,.Manco, M., Mari, A., Baldi, S., Gastaldelli, A., Greco, A.V., Mingrone, G. and .Ferrannini, E. (2005) Beta cell function in morbidly obese subjects during free living. Diabetes, 54, p. 2382-89.
Corbi GM, Carbone S, Ziccardi P, Giugliano G, Marfella R, Nappo F, Paolisso G, Esposito K and Giugiano D. FFAs and QT intervals in obese women with visceral adiposity: effects of sustained weight loss over 1 year. Journal of Clinical Endocrinology & Metabolism 2002; 87(5): 2080-2083.
Ozkan EA, Khosroshahi HE, Serin HI, Ozdamir ZT, Kilic M, Gecit UA and Ekim M. Evaluation of QTc Value and Relation Between QTc Interval and Cardiovascular Risk Factors in Obese Children. American Journal of Health 2015; 3(3): 194-197.
Hlaing ZTT, Hway SM, Yee NN, Sein MT. Serum testosterone level and corrected QT interval (QTc) in non-obese and obese adult male subjects. EC Cardiology 2018; 5(11):805-817.
Aleksandra M, Stokic E, Plecas-Duric A, Popovic D and Ilincic B. Is QTc interval associated with insulin resistance in metabolic syndrome? Cardiology and cardiovascular medicine 2016; 1(1): 26-36.
Frank S, Colliver JA, Frank A. The electrocardiogram in obesity: statically analysis of 1029 patients. J Am Coll Cardiol 1986; 7: 295-299.
This work is licensed under a Creative Commons Attribution 4.0 International License.