| Title: | Associations between prediabetes, type 2 diabetes, and incident arrhythmias: a population-based cohort study and Mendelian randomization analysis |
| Journal: | Diabetes Research and Clinical Practice |
| Published: | 10 Jul 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42431242/ |
| DOI: | https://doi.org/10.1016/j.diabres.2026.113408 |
Publication 20805
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Abstract
BACKGROUND: Type 2 diabetes (T2D) is a known risk factor for arrhythmias, yet evidence for prediabetes is limited, and the two main diagnostic criteria (ADA, prioritizing sensitivity; WHO/IEC, prioritizing specificity) have not been directly compared across arrhythmia subtypes.</p>
METHODS: In this prospective cohort study of 383,995 UK Biobank participants, glycemic status was defined by ADA and WHO/IEC criteria. Outcomes included atrial fibrillation, supraventricular tachycardia, bradyarrhythmia, and ventricular arrhythmia. Cox models were adjusted for clinical, lifestyle, and genetic confounders. Mendelian randomization (MR) was performed to infer causality.</p>
RESULTS: Over a median 13.0 years, prediabetes and T2D were each associated with increased risks of all arrhythmias. Under ADA criteria, prediabetes hazard ratios ranged from 1.12 to 1.16; risks were higher for T2D and for progression from prediabetes to T2D. ECG changes included shortened RR and prolonged QTc intervals.MR analyses provided genetic evidence supporting a potential causal role of dysglycemia in arrhythmogenesis.</p>
CONCLUSIONS: These findings highlight the differential prognostic utility of ADA and WHO/IEC criteria for arrhythmia risk stratification: the ADA criteria offer broader sensitivity for early detection, whereas the stricter WHO/IEC criteria identify a higher-risk subgroup warranting more intensive management.</p>
10 Authors
- Yanjun Song
- Zhihao Zheng
- Kongyong Cui
- Jining He
- Xiaohui Bian
- Chenxi Song
- Qiuting Dong
- Chen Zhu
- Chao Wu
- Kefei Dou
Enabling scientific discoveries that improve human health