Prevalence of ECG abnormalities among adults with metabolic syndrome in a Nigerian Teaching Hospital|
Abiodun, Adeoye; Oladimeji, Adebayo; Bamidele, Tayo; Adewole, Adebiyi & Mayowa, Owolabi
Background: Co-existence of metabolic syndrome (MetS) and electrocardiography (ECG) abnormalities heightens the risk of
sudden cardiac death. However, there is a gap in evidence of how ECG changes cluster among continental Africans with or
Methods: We included 491 participants with interpretable ECG tracings who were consecutively recruited into the Cardiovascular
Risk Prediction Registry (CRP). CRP is a registry of newly presenting patients into cardiology clinic of the University
College Hospital, Nigeria, with a main objective of cardiovascular risk stratification to prevent cardiovascular morbidity and
mortality. Using the International Diabetic Federation (IDF) criteria they were divided into those with metabolic syndrome and
Results: Four hundred and ninety-one participants comprising 48.3% women with mean age 53.72±15.2 years who met the
IDF criteria with complete ECG interpretations were analyzed with 44.2% (men 38.6%; women 50.2%) of the participants having
MetS while 74% had ECG abnormalities. Compared to women, men had higher mean serum total cholesterol, creatinine,
smoking, and alcohol use, family history of hypertension and diabetes mellitus, QT prolongation, LVH plus or minus strain
pattern, and ECG abnormalities in general. Women were heavier, had higher heart rate and proportions of MetS. ECG findings
among those with or without MetS were not significantly different. In men, IDF metabolic score was associated with conduction
abnormalities (p=0.039) and combined ECG abnormality (p=0.042) which became more significant with an exclusion of
QT prolongation (p=0.004). Also, IDF abdominal obesity was associated with QT prolongation (p=0.017), combined ECG
abnormality (p=0.034) while HDLc correlated with ECG abnormalities (0.037) in men. There was no significant associations
of components of metabolic syndrome with ECG abnormalities among women.
Conclusion: There was a high prevalence of MetS and abnormal ECG among the studied population. Abnormal ECG findings
were more common in men with no differential association in people with or without MetS. However, a significant association
existed between certain components of MetS and ECG abnormalities in men only. Male gender and HDLc were independent
predictors of ECG Abnormalities.
Electrocardiography; metabolic syndrome; africans.