QTc Interval Prolongation and Its Association with Albuminuria Severity in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study
Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is associated with multiple microvascular complications, including diabetic nephropathy and cardiac autonomic dysfunction. Prolongation of the corrected QT (QTc) interval has emerged as a potential marker of cardiovascular risk, while albuminuria reflects early renal involvement. This study aimed to evaluate the association between QTc interval prolongation and albuminuria severity in patients with T2DM. Methods: A cross-sectional observational study was conducted among 100 patients with T2DM attending a tertiary care hospital. Clinical evaluation, laboratory investigations, urine albumin-to-creatinine ratio (UACR), and 12-lead electrocardiography were performed. Participants were categorized according to diabetes duration and UACR levels. Statistical analysis included independent Student’s t-test and one-way ANOVA, with p<0.05 considered statistically significant. Results: The mean age of the participants was 60.12±12.14 years, and 62% were females. Diabetic neuropathy and retinopathy were present in 66% and 63% of patients, respectively. Patients with diabetes duration ≥5 years had significantly higher UACR (141.28±75.40 vs. 100.33±64.41 mg/g; p=0.004), QT interval (384.22 ± 44.66 vs. 349.96 ± 43.58 ms; p=0.019), and QTc interval (489.29 ± 51.40 vs. 454.98 ± 50.51 ms; p=0.024) compared to those with shorter disease duration. A significant increase in HbA1c (p=0.005) and QTc interval (p=0.013) was observed across increasing UACR categories, indicating a dose-dependent relationship between albuminuria severity and cardiac repolarization abnormalities. Conclusion: QTc interval prolongation is significantly associated with increasing albuminuria severity, poor glycemic control, and longer diabetes duration. QTc assessment may serve as a simple, non-invasive marker for identifying T2DM patients at increased risk of microvascular and cardiovascular complications.