Background To assess the roles of diabetic microvascular disease and modifiable risk factors and their combination in the development of arrhythmias. Methods We included participants with type 2 diabetes (T2D) who were free of arrhythmias during recruitment in the UK Biobank study. The associations of microvascular disease states (defined by the presence of retinopathy, peripheral neuropathy or chronic kidney disease), four modifiable arrhythmic risk factors (body mass index, smoking, systolic blood pressure and glycosylated haemoglobin) and their joint associations with incident arrhythmias were examined. Results Among the 25 632 participants with T2D, 1705 (20.1%) of the 8482 with microvascular disease and 2017 (11.8%) of the 17 150 without microvascular disease developed arrhythmias during a median follow-up of 12.3 years. Having any of the three microvascular diseases was associated with a 48% increase in the hazard of developing arrhythmias. Incorporating microvascular disease states into a model alongside 11 traditional risk factors significantly enhanced arrhythmia prediction. Furthermore, individuals with microvascular disease who had optimal levels of zero to one, two, three or four arrhythmic risk factors showed an HR of 2.05 (95% CI 1.85, 2.27), 1.67 (95% CI 1.53, 1.83), 1.35 (95% CI 1.22, 1.50) and 0.91 (95% CI 0.73, 1.13), respectively, compared with those without microvascular disease. Conclusions Although microvascular disease, a non-traditional risk factor, was associated with incident arrhythmias in individuals with T2D, having optimal levels of risk factors may mitigate this risk. Data are available upon reasonable request. The data sets used and/or analysed during the current study are available from the corresponding author on reasonable request.

中文翻译：

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2 型糖尿病的微血管疾病、可改变的危险因素和心律失常

背景 评估糖尿病微血管疾病和可改变的危险因素及其组合在心律失常发生中的作用。方法 我们纳入了在英国生物银行研究招募期间未出现心律失常的 2 型糖尿病 (T2D) 参与者。研究了微血管疾病状态（定义为存在视网膜病变、周围神经病变或慢性肾脏疾病）、四种可改变的心律失常危险因素（体重指数、吸烟、收缩压和糖化血红蛋白）之间的关联及其与心律失常事件的联合关联。 。结果 在 25632 名 T2D 参与者中，8482 名患有微血管疾病的参与者中的 1705 名（20.1%）和 2017 名无微血管疾病的 17150 名参与者中的 1705 名（11.8%）在中位随访 12.3 年期间出现心律失常。患有这三种微血管疾病中的任何一种都会导致心律失常的风险增加 48%。将微血管疾病状态与 11 种传统危险因素一起纳入模型可显着增强心律失常的预测。此外，具有 0 到 1、2、3 或 4 个心律失常危险因素最佳水平的微血管疾病个体的 HR 分别为 2.05 (95% CI 1.85, 2.27)、1.67 (95% CI 1.53, 1.83)、1.35 (95与无微血管疾病的患者相比，% CI 分别为 1.22, 1.50) 和 0.91 (95% CI 0.73, 1.13)。结论 尽管微血管疾病（一种非传统危险因素）与 T2D 患者的心律失常相关，但拥有最佳水平的危险因素可能会减轻这种风险。数据可根据合理要求提供。当前研究期间使用和/或分析的数据集可根据合理要求从相应作者处获得。