Cargando…
Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis
BACKGROUND: Hypoglycaemia has been linked to an increased risk of cardiac arrhythmias by causing autonomic and metabolic alterations, which may be associated with detrimental outcomes in individuals with diabetes(IWD), such as cardiovascular diseases (CVDs) and mortality, especially in multimorbid o...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10461564/ https://www.ncbi.nlm.nih.gov/pubmed/37645418 http://dx.doi.org/10.3389/fendo.2023.1222409 |
_version_ | 1785097864133738496 |
---|---|
author | Li, Gangfeng Zhong, Shuping Wang, Xingmu Zhuge, Fuyuan |
author_facet | Li, Gangfeng Zhong, Shuping Wang, Xingmu Zhuge, Fuyuan |
author_sort | Li, Gangfeng |
collection | PubMed |
description | BACKGROUND: Hypoglycaemia has been linked to an increased risk of cardiac arrhythmias by causing autonomic and metabolic alterations, which may be associated with detrimental outcomes in individuals with diabetes(IWD), such as cardiovascular diseases (CVDs) and mortality, especially in multimorbid or frail people. However, such relationships in this population have not been thoroughly investigated. For this reason, we conducted a systematic review and meta-analysis. METHODS: Relevant papers published on PubMed, Embase, Cochrane, Web of Knowledge, Scopus, and CINHAL complete from inception to December 22, 2022 were routinely searched without regard for language. All of the selected articles included odds ratio, hazard ratio, or relative risk statistics, as well as data for estimating the connection of hypoglycaemia with cardiac arrhythmia, CVD-induced death, or total death in IWD. Regardless of the heterogeneity assessed by the I(2) statistic, pooled relative risks (RRs) and 95% confidence intervals (CI) were obtained using random-effects models. RESULTS: After deleting duplicates and closely evaluating all screened citations, we chose 60 studies with totally 5,960,224 participants for this analysis. Fourteen studies were included in the arrhythmia risk analysis, and 50 in the analysis of all-cause mortality. Hypoglycaemic patients had significantly higher risks of arrhythmia occurrence (RR 1.42, 95%CI 1.21-1.68), CVD-induced death (RR 1.59, 95% CI 1.24-2.04), and all-cause mortality (RR 1.68, 95% CI 1.49-1.90) compared to euglycaemic patients with significant heterogeneity. CONCLUSION: Hypoglycaemic individuals are more susceptible to develop cardiac arrhythmias and die, but evidence of potential causal linkages beyond statistical associations must await proof by additional specifically well planned research that controls for all potential remaining confounding factors. |
format | Online Article Text |
id | pubmed-10461564 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104615642023-08-29 Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis Li, Gangfeng Zhong, Shuping Wang, Xingmu Zhuge, Fuyuan Front Endocrinol (Lausanne) Endocrinology BACKGROUND: Hypoglycaemia has been linked to an increased risk of cardiac arrhythmias by causing autonomic and metabolic alterations, which may be associated with detrimental outcomes in individuals with diabetes(IWD), such as cardiovascular diseases (CVDs) and mortality, especially in multimorbid or frail people. However, such relationships in this population have not been thoroughly investigated. For this reason, we conducted a systematic review and meta-analysis. METHODS: Relevant papers published on PubMed, Embase, Cochrane, Web of Knowledge, Scopus, and CINHAL complete from inception to December 22, 2022 were routinely searched without regard for language. All of the selected articles included odds ratio, hazard ratio, or relative risk statistics, as well as data for estimating the connection of hypoglycaemia with cardiac arrhythmia, CVD-induced death, or total death in IWD. Regardless of the heterogeneity assessed by the I(2) statistic, pooled relative risks (RRs) and 95% confidence intervals (CI) were obtained using random-effects models. RESULTS: After deleting duplicates and closely evaluating all screened citations, we chose 60 studies with totally 5,960,224 participants for this analysis. Fourteen studies were included in the arrhythmia risk analysis, and 50 in the analysis of all-cause mortality. Hypoglycaemic patients had significantly higher risks of arrhythmia occurrence (RR 1.42, 95%CI 1.21-1.68), CVD-induced death (RR 1.59, 95% CI 1.24-2.04), and all-cause mortality (RR 1.68, 95% CI 1.49-1.90) compared to euglycaemic patients with significant heterogeneity. CONCLUSION: Hypoglycaemic individuals are more susceptible to develop cardiac arrhythmias and die, but evidence of potential causal linkages beyond statistical associations must await proof by additional specifically well planned research that controls for all potential remaining confounding factors. Frontiers Media S.A. 2023-08-14 /pmc/articles/PMC10461564/ /pubmed/37645418 http://dx.doi.org/10.3389/fendo.2023.1222409 Text en Copyright © 2023 Li, Zhong, Wang and Zhuge https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Li, Gangfeng Zhong, Shuping Wang, Xingmu Zhuge, Fuyuan Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis |
title | Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis |
title_full | Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis |
title_fullStr | Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis |
title_full_unstemmed | Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis |
title_short | Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis |
title_sort | association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10461564/ https://www.ncbi.nlm.nih.gov/pubmed/37645418 http://dx.doi.org/10.3389/fendo.2023.1222409 |
work_keys_str_mv | AT ligangfeng associationofhypoglycaemiawiththerisksofarrhythmiaandmortalityinindividualswithdiabetesasystematicreviewandmetaanalysis AT zhongshuping associationofhypoglycaemiawiththerisksofarrhythmiaandmortalityinindividualswithdiabetesasystematicreviewandmetaanalysis AT wangxingmu associationofhypoglycaemiawiththerisksofarrhythmiaandmortalityinindividualswithdiabetesasystematicreviewandmetaanalysis AT zhugefuyuan associationofhypoglycaemiawiththerisksofarrhythmiaandmortalityinindividualswithdiabetesasystematicreviewandmetaanalysis |