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Published in: BMC Cardiovascular Disorders 1/2024

Open Access 01-12-2024 | Type 2 Diabetes | Research

Association of T-wave electrocardiogram changes and type 2 diabetes: a cross-sectional sub-analysis of the MASHAD cohort population using the Minnesota coding system

Authors: Sara Soflaei Saffar, Eisa Nazar, Toktam Sahranavard, Farzad Fayedeh, AmirAli Moodi Ghalibaf, Mahmoud Ebrahimi, Hedieh Alimi, Bahram Shahri, Azadeh Izadi-Moud, Gordon A. Ferns, Alireza Ghodsi, Saeed Mehrabi, Milad Tarhimi, Habibollah Esmaily, Mohsen Moohebati, Majid Ghayour-Mobarhan

Published in: BMC Cardiovascular Disorders | Issue 1/2024

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Abstract

Background

Type 2 Diabetes Mellitus (T2DM) has become a major health concern with an increasing prevalence and is now one of the leading attributable causes of death globally. T2DM and cardiovascular disease are strongly associated and T2DM is an important independent risk factor for ischemic heart disease. T-wave abnormalities (TWA) on electrocardiogram (ECG) can indicate several pathologies including ischemia. In this study, we aimed to investigate the association between T2DM and T-wave changes using the Minnesota coding system.

Methods

A cross-sectional study was conducted on the MASHAD cohort study population. All participants of the cohort population were enrolled in the study. 12-lead ECG and Minnesota coding system (codes 5–1 to 5–4) were utilized for T-wave observation and interpretation. Regression models were used for the final evaluation with a level of significance being considered at p < 0.05.

Results

A total of 9035 participants aged 35–65 years old were included in the study, of whom 1273 were diabetic. The prevalence of code 5–2, 5–3, major and minor TWA were significantly higher in diabetics (p < 0.05). However, following adjustment for age, gender, and hypertension, the presence of TWAs was not significantly associated with T2DM (p > 0.05). Hypertension, age, and body mass index were significantly associated with T2DM (p < 0.05).

Conclusions

Although some T-wave abnormalities were more frequent in diabetics, they were not statistically associated with the presence of T2DM in our study.
Literature
1.
go back to reference Duan D, Kengne AP, Echouffo-Tcheugui JB. Screening for diabetes and prediabetes. Endocrinol Metab Clin North Am. 2021;50(3):369–85. Duan D, Kengne AP, Echouffo-Tcheugui JB. Screening for diabetes and prediabetes. Endocrinol Metab Clin North Am. 2021;50(3):369–85.
2.
go back to reference Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018;14(2):88–98.PubMedCrossRef Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018;14(2):88–98.PubMedCrossRef
3.
go back to reference Ali MK, Narayan KM, Tandon N. Diabetes & coronary heart disease: current perspectives. Indian J Med Res. 2010;132(5):584–97.PubMedPubMedCentral Ali MK, Narayan KM, Tandon N. Diabetes & coronary heart disease: current perspectives. Indian J Med Res. 2010;132(5):584–97.PubMedPubMedCentral
4.
go back to reference de Jong M, Woodward M, Peters SAE. Diabetes, glycated hemoglobin, and the risk of myocardial infarction in women and men: a prospective cohort study of the UK Biobank. Diabetes Care. 2020;43(9):2050–9.PubMedCrossRef de Jong M, Woodward M, Peters SAE. Diabetes, glycated hemoglobin, and the risk of myocardial infarction in women and men: a prospective cohort study of the UK Biobank. Diabetes Care. 2020;43(9):2050–9.PubMedCrossRef
5.
go back to reference Shaw JA, Cooper ME. Contemporary management of heart failure in patients with diabetes. Diabetes Care. 2020;43(12):2895–903.PubMedCrossRef Shaw JA, Cooper ME. Contemporary management of heart failure in patients with diabetes. Diabetes Care. 2020;43(12):2895–903.PubMedCrossRef
6.
go back to reference Chen Y, Hua Y, Li X, Arslan IM, Zhang W, Meng G. Distinct types of cell death and the implication in diabetic cardiomyopathy. Front Pharmacol. 2020;11:42.PubMedPubMedCentralCrossRef Chen Y, Hua Y, Li X, Arslan IM, Zhang W, Meng G. Distinct types of cell death and the implication in diabetic cardiomyopathy. Front Pharmacol. 2020;11:42.PubMedPubMedCentralCrossRef
8.
go back to reference Kayama Y, Raaz U, Jagger A, Adam M, Schellinger IN, Sakamoto M, et al. Diabetic cardiovascular disease induced by oxidative stress. Int J of Mol Sci. 2015;16(10):25234–63.CrossRef Kayama Y, Raaz U, Jagger A, Adam M, Schellinger IN, Sakamoto M, et al. Diabetic cardiovascular disease induced by oxidative stress. Int J of Mol Sci. 2015;16(10):25234–63.CrossRef
9.
go back to reference Taskinen M-R. Diabetic dyslipidemia. Atherosclerosis Supp. 2002;3(1):47–51.CrossRef Taskinen M-R. Diabetic dyslipidemia. Atherosclerosis Supp. 2002;3(1):47–51.CrossRef
10.
go back to reference Dokken BB. The pathophysiology of cardiovascular disease and diabetes: beyond blood pressure and lipids. Diabetes Spectr. 2008;21(3):160–5.CrossRef Dokken BB. The pathophysiology of cardiovascular disease and diabetes: beyond blood pressure and lipids. Diabetes Spectr. 2008;21(3):160–5.CrossRef
11.
go back to reference Lontchi-Yimagou E, Sobngwi E, Matsha TE, Kengne AP. Diabetes mellitus and inflammation. Current Diab Rep. 2013;13(3):435–44.CrossRef Lontchi-Yimagou E, Sobngwi E, Matsha TE, Kengne AP. Diabetes mellitus and inflammation. Current Diab Rep. 2013;13(3):435–44.CrossRef
12.
go back to reference Ghalibaf AM, Soflaei SS, Ferns GA, Saberi-Karimian M, Ghayour-Mobarhan M. Association between dietary copper and cardiovascular disease: a narrative review. J Trace Elem Med Biol. 2023;80:127255. Ghalibaf AM, Soflaei SS, Ferns GA, Saberi-Karimian M, Ghayour-Mobarhan M. Association between dietary copper and cardiovascular disease: a narrative review. J Trace Elem Med Biol. 2023;80:127255.
13.
go back to reference Selvaraju V, Joshi M, Suresh S, Sanchez JA, Maulik N, Maulik G. Diabetes, oxidative stress, molecular mechanism, and cardiovascular disease–an overview. Toxicol Mech Method. 2012;22(5):330–5.CrossRef Selvaraju V, Joshi M, Suresh S, Sanchez JA, Maulik N, Maulik G. Diabetes, oxidative stress, molecular mechanism, and cardiovascular disease–an overview. Toxicol Mech Method. 2012;22(5):330–5.CrossRef
14.
go back to reference Domingueti CP, Dusse LMSA, das Graças Carvalh M, de Sousa LP, Gomes KB, Fernandes AP. Diabetes mellitus: the linkage between oxidative stress, inflammation, hypercoagulability and vascular complications. J Diabetes Complications. 2016;30(4):738–45.PubMedCrossRef Domingueti CP, Dusse LMSA, das Graças Carvalh M, de Sousa LP, Gomes KB, Fernandes AP. Diabetes mellitus: the linkage between oxidative stress, inflammation, hypercoagulability and vascular complications. J Diabetes Complications. 2016;30(4):738–45.PubMedCrossRef
15.
16.
go back to reference Berkaya SK, Uysal AK, Gunal ES, Ergin S, Gunal S, Gulmezoglu MB. A survey on ECG analysis. Biomed Signal Process Control. 2018;43:216–35.CrossRef Berkaya SK, Uysal AK, Gunal ES, Ergin S, Gunal S, Gulmezoglu MB. A survey on ECG analysis. Biomed Signal Process Control. 2018;43:216–35.CrossRef
18.
go back to reference Krittayaphong R, Muenkaew M, Chiewvit P, Ratanasit N, Kaolawanich Y, Phrommintikul A. Electrocardiographic predictors of cardiovascular events in patients at high cardiovascular risk: a multicenter study. J Geriatr Cardiol. 2019;16(8):630–8.PubMedPubMedCentral Krittayaphong R, Muenkaew M, Chiewvit P, Ratanasit N, Kaolawanich Y, Phrommintikul A. Electrocardiographic predictors of cardiovascular events in patients at high cardiovascular risk: a multicenter study. J Geriatr Cardiol. 2019;16(8):630–8.PubMedPubMedCentral
19.
go back to reference Saffar Soflaei S, Ebrahimi M, Rahimi HR, Moodi Ghalibaf A, Jafari M, Alimi H, et al. A large population-based study on the prevalence of electrocardiographic abnormalities: a result of Mashhad stroke and heart atherosclerotic disorder cohort study. Ann Noninvasive Electrocardiol. 2023;28:e13086. Saffar Soflaei S, Ebrahimi M, Rahimi HR, Moodi Ghalibaf A, Jafari M, Alimi H, et al. A large population-based study on the prevalence of electrocardiographic abnormalities: a result of Mashhad stroke and heart atherosclerotic disorder cohort study. Ann Noninvasive Electrocardiol. 2023;28:e13086.
20.
go back to reference Channer K, Morris F. ABC of clinical electrocardiography: myocardial ischaemia. BMJ. 2002;324(7344):1023–6. Channer K, Morris F. ABC of clinical electrocardiography: myocardial ischaemia. BMJ. 2002;324(7344):1023–6.
21.
go back to reference Hanna EB, Glancy DL. ST-segment depression and T-wave inversion: classification, differential diagnosis, and caveats. Cleve Clin J Med. 2011;78(6):404.PubMedCrossRef Hanna EB, Glancy DL. ST-segment depression and T-wave inversion: classification, differential diagnosis, and caveats. Cleve Clin J Med. 2011;78(6):404.PubMedCrossRef
22.
go back to reference Migliore F, Zorzi A, Michieli P, Perazzolo Marra M, Siciliano M, Rigato I, et al. Prevalence of cardiomyopathy in Italian asymptomatic children with electrocardiographic T-wave inversion at preparticipation screening. Circulation. 2012;125(3):529–38.PubMedCrossRef Migliore F, Zorzi A, Michieli P, Perazzolo Marra M, Siciliano M, Rigato I, et al. Prevalence of cardiomyopathy in Italian asymptomatic children with electrocardiographic T-wave inversion at preparticipation screening. Circulation. 2012;125(3):529–38.PubMedCrossRef
23.
go back to reference Surawicz B, Lasseter KC. Electrocardiogram in pericarditis. Am J of Cardiol. 1970;26(5):471–4.CrossRef Surawicz B, Lasseter KC. Electrocardiogram in pericarditis. Am J of Cardiol. 1970;26(5):471–4.CrossRef
24.
go back to reference Ghayour-Mobarhan M, Moohebati M, Esmaily H, Ebrahimi M, Parizadeh SM, Heidari-Bakavoli AR, et al. Mashhad stroke and heart atherosclerotic disorder (MASHAD) study: design, baseline characteristics and 10-year cardiovascular risk estimation. Int J Public Health. 2015;60(5):561–72.PubMedCrossRef Ghayour-Mobarhan M, Moohebati M, Esmaily H, Ebrahimi M, Parizadeh SM, Heidari-Bakavoli AR, et al. Mashhad stroke and heart atherosclerotic disorder (MASHAD) study: design, baseline characteristics and 10-year cardiovascular risk estimation. Int J Public Health. 2015;60(5):561–72.PubMedCrossRef
25.
go back to reference James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507–20.PubMedCrossRef James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507–20.PubMedCrossRef
26.
go back to reference Catamo E, Tornese G, Concas MP, Gasparini P, Robino A. Differences in taste and smell perception between type 2 diabetes mellitus patients and healthy controls. Nutr Metab Cardiovasc Dis. 2021;31(1):193–200.PubMedCrossRef Catamo E, Tornese G, Concas MP, Gasparini P, Robino A. Differences in taste and smell perception between type 2 diabetes mellitus patients and healthy controls. Nutr Metab Cardiovasc Dis. 2021;31(1):193–200.PubMedCrossRef
27.
go back to reference Hong SH, Noh E, Kim J, Hwang SY, Kim JA, Lee YB, et al. Fasting plasma glucose variability and gastric cancer risk in individuals without diabetes mellitus: a nationwide population-based cohort study. Clin Transl Gastroenterol. 2020;11(9):e00221.PubMedPubMedCentralCrossRef Hong SH, Noh E, Kim J, Hwang SY, Kim JA, Lee YB, et al. Fasting plasma glucose variability and gastric cancer risk in individuals without diabetes mellitus: a nationwide population-based cohort study. Clin Transl Gastroenterol. 2020;11(9):e00221.PubMedPubMedCentralCrossRef
28.
go back to reference Prineas RJ, Crow RS, Zhang Z-M. The Minnesota code manual of electrocardiographic findings: Springer Science & Business Media. 2009. Prineas RJ, Crow RS, Zhang Z-M. The Minnesota code manual of electrocardiographic findings: Springer Science & Business Media. 2009.
29.
go back to reference Le Feuvre C, Jacqueminet S, Barthelemy O. Myocardial ischemia: a silent epidemic in type 2 diabetes patients. Future Cardiol. 2011;7(2):183–90. Le Feuvre C, Jacqueminet S, Barthelemy O. Myocardial ischemia: a silent epidemic in type 2 diabetes patients. Future Cardiol. 2011;7(2):183–90.
30.
go back to reference Raza JA, Movahed A. Current concepts of cardiovascular diseases in diabetes mellitus. Int J Cardiol. 2003;89(2–3):123–34.CrossRef Raza JA, Movahed A. Current concepts of cardiovascular diseases in diabetes mellitus. Int J Cardiol. 2003;89(2–3):123–34.CrossRef
31.
go back to reference Conti C, Mehta J. Acute myocardial ischemia: role of atherosclerosis, thrombosis, platelet activation, coronary vasospasm, and altered arachidonic acid metabolism. Circulation. 1987;75(6 Pt 2):V84–95.PubMed Conti C, Mehta J. Acute myocardial ischemia: role of atherosclerosis, thrombosis, platelet activation, coronary vasospasm, and altered arachidonic acid metabolism. Circulation. 1987;75(6 Pt 2):V84–95.PubMed
32.
go back to reference Smit M, Coetzee A, Lochner A. The pathophysiology of myocardial ischemia and perioperative myocardial infarction. J Cardiothorac Vasc Anesth. 2020;34(9):2501–12.PubMedCrossRef Smit M, Coetzee A, Lochner A. The pathophysiology of myocardial ischemia and perioperative myocardial infarction. J Cardiothorac Vasc Anesth. 2020;34(9):2501–12.PubMedCrossRef
34.
go back to reference Vazzana N, Ranalli P, Cuccurullo C, Davì G. Diabetes mellitus and thrombosis. Thromb Res. 2012;129(3):371–7.PubMedCrossRef Vazzana N, Ranalli P, Cuccurullo C, Davì G. Diabetes mellitus and thrombosis. Thromb Res. 2012;129(3):371–7.PubMedCrossRef
35.
36.
go back to reference Henning RJ. Type-2 diabetes mellitus and cardiovascular disease. Future Cardiol. 2018;14(6):491–509.PubMedCrossRef Henning RJ. Type-2 diabetes mellitus and cardiovascular disease. Future Cardiol. 2018;14(6):491–509.PubMedCrossRef
37.
go back to reference Goh S-Y, Cooper ME. The role of advanced glycation end products in progression and complications of diabetes. J Clin Endocrinol Metab. 2008;93(4):1143–52.PubMedCrossRef Goh S-Y, Cooper ME. The role of advanced glycation end products in progression and complications of diabetes. J Clin Endocrinol Metab. 2008;93(4):1143–52.PubMedCrossRef
38.
go back to reference Sousa MM, Du Yan S, Stern D, Saraiva MJ. Interaction of the receptor for advanced glycation end products (RAGE) with transthyretin triggers nuclear transcription factor kB (NF-kB) activation. Lab Invest. 2000;80(7):1101–10.PubMedCrossRef Sousa MM, Du Yan S, Stern D, Saraiva MJ. Interaction of the receptor for advanced glycation end products (RAGE) with transthyretin triggers nuclear transcription factor kB (NF-kB) activation. Lab Invest. 2000;80(7):1101–10.PubMedCrossRef
39.
go back to reference Basta G, Schmidt AM, De Caterina R. Advanced glycation end products and vascular inflammation: implications for accelerated atherosclerosis in diabetes. Cardiovasc Res. 2004;63(4):582–92.PubMedCrossRef Basta G, Schmidt AM, De Caterina R. Advanced glycation end products and vascular inflammation: implications for accelerated atherosclerosis in diabetes. Cardiovasc Res. 2004;63(4):582–92.PubMedCrossRef
40.
go back to reference Severino P, D’Amato A, Netti L, Pucci M, Infusino F, Maestrini V, et al. Myocardial ischemia and diabetes mellitus: role of oxidative stress in the connection between cardiac metabolism and coronary blood flow. J Diabetes Res. 2019;2019:9489826. Severino P, D’Amato A, Netti L, Pucci M, Infusino F, Maestrini V, et al. Myocardial ischemia and diabetes mellitus: role of oxidative stress in the connection between cardiac metabolism and coronary blood flow. J Diabetes Res. 2019;2019:9489826.
41.
go back to reference Mould SJ, Soliman EZ, Bertoni AG, Bhave PD, Yeboah J, Singleton MJ. Association of T-wave abnormalities with major cardiovascular events in diabetes: the ACCORD trial. Diabetologia. 2021;64(3):504–11.PubMedCrossRef Mould SJ, Soliman EZ, Bertoni AG, Bhave PD, Yeboah J, Singleton MJ. Association of T-wave abnormalities with major cardiovascular events in diabetes: the ACCORD trial. Diabetologia. 2021;64(3):504–11.PubMedCrossRef
42.
go back to reference Harms PP, Elders P, Rutters F, Lissenberg-Witte BI, Tan HL, Beulens JWJ, et al. Longitudinal association of electrocardiogram abnormalities with major adverse cardiac events in people with Type 2 diabetes: the Hoorn Diabetes Care System cohort. Eur J Prev Cardiol. 2023;30(8):624–33.PubMedCrossRef Harms PP, Elders P, Rutters F, Lissenberg-Witte BI, Tan HL, Beulens JWJ, et al. Longitudinal association of electrocardiogram abnormalities with major adverse cardiac events in people with Type 2 diabetes: the Hoorn Diabetes Care System cohort. Eur J Prev Cardiol. 2023;30(8):624–33.PubMedCrossRef
43.
go back to reference Kale T, Agrawal H, Pandit R, Naheed Z. T-wave inversion in diabetic ketoacidosis with normokalemia in an adolescent. Pediatr Cardiol. 2013;34:1508–10.PubMedCrossRef Kale T, Agrawal H, Pandit R, Naheed Z. T-wave inversion in diabetic ketoacidosis with normokalemia in an adolescent. Pediatr Cardiol. 2013;34:1508–10.PubMedCrossRef
44.
go back to reference Gerdts E, Gulam-Abbas Z, Lutale J, Thordarson H, Vetvik K. Prevalence and covariates of electrocardiographic left ventricular hypertrophy in diabetic patients in Tanzania: Cardiovascular Topics. Cardiovasc J Afr. 2008;19:8–14. Gerdts E, Gulam-Abbas Z, Lutale J, Thordarson H, Vetvik K. Prevalence and covariates of electrocardiographic left ventricular hypertrophy in diabetic patients in Tanzania: Cardiovascular Topics. Cardiovasc J Afr. 2008;19:8–14.
45.
go back to reference Dickinson S, Rogers T, Kasiske B, Bertog S, Tadros G, Malik J, et al. Coronary artery disease in young women and men with long-standing insulin-dependent diabetes. Angiology. 2008;59(1):9–15.PubMedCrossRef Dickinson S, Rogers T, Kasiske B, Bertog S, Tadros G, Malik J, et al. Coronary artery disease in young women and men with long-standing insulin-dependent diabetes. Angiology. 2008;59(1):9–15.PubMedCrossRef
46.
go back to reference Cardoso CR, Leite NC, Salles GF. Factors associated with abnormal T-wave axis and increased QRS-T angle in type 2 diabetes. Acta Diabetol. 2013;50(6):919–25.PubMedCrossRef Cardoso CR, Leite NC, Salles GF. Factors associated with abnormal T-wave axis and increased QRS-T angle in type 2 diabetes. Acta Diabetol. 2013;50(6):919–25.PubMedCrossRef
47.
go back to reference Yu L, Ye X, Yang Z, Yang W, Zhang B. Prevalences and associated factors of electrocardiographic abnormalities in Chinese adults: a cross-sectional study. BMC Cardiovasc Disord. 2020;20(1):414.PubMedPubMedCentralCrossRef Yu L, Ye X, Yang Z, Yang W, Zhang B. Prevalences and associated factors of electrocardiographic abnormalities in Chinese adults: a cross-sectional study. BMC Cardiovasc Disord. 2020;20(1):414.PubMedPubMedCentralCrossRef
48.
go back to reference Isaksen JL, Graff C, Ellervik C, Jensen JS, Andersen HU, Rossing P, et al. Type 1 diabetes is associated with T-wave morphology changes. The Thousand & 1 Study. J Electrocardiol. 2018;51(6s):S72–s7.PubMedCrossRef Isaksen JL, Graff C, Ellervik C, Jensen JS, Andersen HU, Rossing P, et al. Type 1 diabetes is associated with T-wave morphology changes. The Thousand & 1 Study. J Electrocardiol. 2018;51(6s):S72–s7.PubMedCrossRef
49.
go back to reference Assanelli D, Di Castelnuovo A, Rago L, Badilini F, Vinetti G, Gianfagna F, et al. T-wave axis deviation and left ventricular hypertrophy interaction in diabetes and hypertension. J Electrocardiol. 2013;46(6):487–91.PubMedCrossRef Assanelli D, Di Castelnuovo A, Rago L, Badilini F, Vinetti G, Gianfagna F, et al. T-wave axis deviation and left ventricular hypertrophy interaction in diabetes and hypertension. J Electrocardiol. 2013;46(6):487–91.PubMedCrossRef
50.
go back to reference Tesfaye B, Alebel A, Gebrie A, Zegeye A, Tesema Leshargie C, Ferede A, et al. Diabetes mellitus and its association with hypertension in Ethiopia: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2019;156:107838.PubMedCrossRef Tesfaye B, Alebel A, Gebrie A, Zegeye A, Tesema Leshargie C, Ferede A, et al. Diabetes mellitus and its association with hypertension in Ethiopia: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2019;156:107838.PubMedCrossRef
51.
go back to reference Sahay BK, Sahay RK. Hypertension in diabetes. J Indian Med Assoc. 2003;101(1):12, 4–5, 44. Sahay BK, Sahay RK. Hypertension in diabetes. J Indian Med Assoc. 2003;101(1):12, 4–5, 44.
52.
go back to reference Tramunt B, Smati S, Grandgeorge N, Lenfant F, Arnal JF, Montagner A, et al. Sex differences in metabolic regulation and diabetes susceptibility. Diabetologia. 2020;63(3):453–61.PubMedCrossRef Tramunt B, Smati S, Grandgeorge N, Lenfant F, Arnal JF, Montagner A, et al. Sex differences in metabolic regulation and diabetes susceptibility. Diabetologia. 2020;63(3):453–61.PubMedCrossRef
53.
go back to reference Mirzaei M, Rahmaninan M, Mirzaei M, Nadjarzadeh A, Dehghanitafti AA. Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes in Central Iran: results from Yazd health study. BMC Public Health. 2020;20(1):166.PubMedPubMedCentralCrossRef Mirzaei M, Rahmaninan M, Mirzaei M, Nadjarzadeh A, Dehghanitafti AA. Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes in Central Iran: results from Yazd health study. BMC Public Health. 2020;20(1):166.PubMedPubMedCentralCrossRef
54.
go back to reference Ciarambino T, Crispino P, Leto G, Mastrolorenzo E, Para O, Giordano M. Influence of gender in diabetes mellitus and its complication. Int J Mol Sci. 2022;23(16):8850. Ciarambino T, Crispino P, Leto G, Mastrolorenzo E, Para O, Giordano M. Influence of gender in diabetes mellitus and its complication. Int J Mol Sci. 2022;23(16):8850.
55.
go back to reference Regensteiner JG, Reusch JEB. Sex differences in cardiovascular consequences of hypertension, obesity, and diabetes: JACC focus seminar 4/7. J Am Coll Cardiol. 2022;79(15):1492–505.PubMedPubMedCentralCrossRef Regensteiner JG, Reusch JEB. Sex differences in cardiovascular consequences of hypertension, obesity, and diabetes: JACC focus seminar 4/7. J Am Coll Cardiol. 2022;79(15):1492–505.PubMedPubMedCentralCrossRef
Metadata
Title
Association of T-wave electrocardiogram changes and type 2 diabetes: a cross-sectional sub-analysis of the MASHAD cohort population using the Minnesota coding system
Authors
Sara Soflaei Saffar
Eisa Nazar
Toktam Sahranavard
Farzad Fayedeh
AmirAli Moodi Ghalibaf
Mahmoud Ebrahimi
Hedieh Alimi
Bahram Shahri
Azadeh Izadi-Moud
Gordon A. Ferns
Alireza Ghodsi
Saeed Mehrabi
Milad Tarhimi
Habibollah Esmaily
Mohsen Moohebati
Majid Ghayour-Mobarhan
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Type 2 Diabetes
Published in
BMC Cardiovascular Disorders / Issue 1/2024
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-023-03649-2

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