scholarly journals The role of the IRS1 gene (rs2943640) in the comorbid course of type 2 diabetes mellitus, obesity and arterial hypertension

2021 ◽  
Vol 11 (1) ◽  
pp. 388-399
Author(s):  
I. Vivsiana ◽  
H. Habor ◽  
M. Marushchak

Type 2 diabetes mellitus (T2DM) affects more than 7 million people, resulting in 2.8 million hospitalizations and more than 300,000 deaths reported annually. Current scientific data indicate that among the world's population, arterial hypertension (AH) and type 2 diabetes mellitus (T2DM) after obesity are among the leading factors of cardiovascular risk. Aim of research: was to establish the prevalence of the IRS1 gene (rs2943640) polymorphism in patients with T2DM in combination with obesity and arterial hypertension/ Material and research methods. The study involved 33 type-2 diabetic patients hospitalized to the Endocrinology Department of Ternopil University Hospital (Ternopil, Ukraine) in 2019-2020 and 10 healthy individuals. Inclusion criteria: clinical, laboratory and instrumental signs of T2DM, AH and obesity. Exclusion criteria from the study: signs of clinically significant neurological, mental, renal, hepatic, immune, gastrointestinal, urogenital disorder; injuries of the musculoskeletal system, skin, sense organs, endocrine system (except T2DM); or uncontrolled hematologic diseases; acute pancreatitis, unstable or life-threatening heart disease; patients with malignant neoplasms who have not been in complete remission for at least 5 years, medication (drug) dependence, and alcohol dependence. T2DM diagnoses were confirmed according to the 2019 Recommendations of the American Diabetes Association (ADA). The diagnosis of arterial hypertension (Stage I) was made according to 2018 ESC/ESH Guidelines for the management of arterial hypertension. Systolic (140-159 mmHg) and/or diastolic (90-99 mmHg) blood pressure were considered as the presence of Stage I AH. Left ventricular hypertrophy was confirmed by an electrocardiogram. Genomic DNA was extracted from peripheral blood leukocytes using a commercially available DNA isolation kit (QIAamp Blood DNA Mini Kit, QIAGEN, Germany). The IRS-1 gene rs2943640 C>A polymorphism was genotyped using the TaqMan real-time PCR method (Applied Biosystems, Foster City, CA, USA). Statistical analysis of the data was performed using the software STATISTICA 7.0. Results. The frequency distribution of the IRS1 gene (rs2943640) polymorphisms and the assessment of compliance with the Hardy – Weinberg equilibrium were performed in the experimental and control groups. It was found that the frequencies of the genotype responsible for C/A polymorphism of the IRS1 gene at T2DM, T2DM with obesity and in the combined course of T2DM with obesity and arterial hypertension did not deviate from the Hardy – Weinberg equilibrium (p> 0.05), while in the control group the selected sample did not correspond to the general population. The corresponding frequencies for the genotypes of the IRS1 gene were as follows: 66.7% for C/A and 33.3% for A/A in the experimental group 1; 42.9% for C/C, 57.1% for C/A in group 2; 47.1% for C/C, 29.4% for C/A and 23.5% for A/A in group 3 and 100.0% for C/A in the control group. Analysis of allele frequencies for the IRS1 gene in patients with T2DM and comorbidity showed that in patients with T2DM the A allele prevailed (2.0 times), while in patients with T2DM + obesity and T2DM + obesity + arterial hypertension – the C allele. It should be noted that the C allele and the A allele were equally present in the control group. Analysis of the odds ratio for IRS1 gene genotypes (rs2943640) in patients with T2DM, T2DM and obesity showed no statistically significant relationship between factor (presence of C or A alleles) and disease onset (p> 0.05). At the same time, the significant influence of the C/A genotype of the IRS1 gene on the development of T2DM combined with obesity and arterial hypertension (p <0.05) was established. This is confirmed by a significant difference in the dominant model of inheritance of the IRS1 gene only in the group with the combination of T2DM with obesity and arterial hypertension compared with the control group (reliability coefficient for the chi-square p <0.001). Conclusion. The presence of the C allele of the IRS1 gene (rs2943640) in both homozygous and heterozygous states may increase the risk of comorbid course of T2DM, obesity and arterial hypertension.

2019 ◽  
Vol 6 (3) ◽  
pp. 132-136
Author(s):  
O. Bilovol ◽  
V. Nemtsova ◽  
I. Ilchenko ◽  
V. Zlatkina

Abstract. INFLUENCE OF HORMONAL DISORDERS ON ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND COMORBIDE ENDOCRINOPATHIES Bilovol O.M., Nemtsova V.D., Ilchenko I.A., Zlatkina V.V. Purpose: to investigate the effect of hormonal changes on endothelial dysfunction (ED) in patients with a comorbid course of hypertension (H), type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SHT). Methods: 183 patients with  H stage II were divided into 3 groups: Group 1 (n=50) - with isolated H (comparison group); Group 2 (n=63) - with a combined course of H and T2DM; Group 3 (n=70) - with comorbidity of H, T2DM and SHT. Blood pressure levels, carbohydrate, lipid and thyroid metabolism, plasma insulin concentration, insulin resistance (IR) the HOMA-IR index, vascular endothelial growth factor (VEGF-A) plasma levels were investigated. Results: Dyslipidemia was more pronounced in group 2 than in group 1. The addition of SHT was accompanied by a tendency to increase all the atherogenic lipids. IR was observed in all patients groups and was significantly higher than in control group (p<0.05). Significant increase of VEGF-A levels in all patients groups in comparison with the control (p<0.05) was found. In group 2 VEGF-A was lower than in group 1, which is probably due to the protective effect of metformin. Analysis  of the influence of thyroid dysfunction degree on ED revealed significant increase of VEGF-A levels in TSH>6.0 μMU/ml subgroup (352.55±17.64 pg/ml vs 461.74±20.13 pg/ml (p<0.05)). Conclusion: Hormonal disorders contribute to aggravation of endothelial dysfunction in patients with hypertension and comorbid endocrinopathies - type 2 diabetes mellitus and subclinical hypothyroidism. Even minor decrease in thyroid function lead to the progression of endothelial dysfunction. Key words: hypertension, type 2 diabetes mellitus, subclinical hypothyroidism, endothelial dysfunction   Резюме. ВПЛИВ ГОРМОНАЛЬНИХ ПОРУШЕНЬ НА ЕНДОТЕЛІАЛЬНУ ДИСФУНКЦІЮ УПАЦІЄНТІВ З АРТЕРІАЛЬНОЮ ГІПЕРТЕНЗІЄЮ ТА КОМОРБІДНИМИ ЕНДОКРИНОПАТІЯМИ Біловол О.М., Немцова В.Д., Ільченко І.А., Златкіна В.В. Мета: дослідити вплив гормональних змін на ендотеліальну дисфункцію (ЕД) у пацієнтів з коморбідним перебігом артеріальної гіпертензії (АГ), цукрового діабету 2 типу (ЦД2Т) тасубклінічного гіпотиреозу (СГТ). Матеріали та методи: 183 пацієнта з АГ II стадії були розділені на 3 групи: 1-а група (n=50) - з ізольованою АГ (група порівняння); Група 2 (n=63) - з поєднаним перебігом АГ та ЦД2Т; Група 3 (n 70) – з комбінованим перебігом АГ, ЦД2Т і СГТ. Вивчали рівні артеріального тиску, показники вуглеводного, ліпідного і тиреоїдного обміну, концентрацію інсуліну в плазмі, індекс інсулінорезистентності (ІР) - HOMA-IR, рівні васкулоендотеліального фактора росту (VEGF-A) в плазмі. Результати. Ступінь дисліпідемії у 2-й групі була більш вираженою, ніж в 1-й. Приєднання СГТ супроводжувалося тенденцією до збільшення всіх атерогенних фракцій ліпідів. ІР спостерігалася у всіх групах пацієнтів і була достовірно більше, ніж у контрольній групі (р<0,05). Виявлено достовірне підвищення рівнів VEGF-A у всіх групах пацієнтів в порівнянні з контролем (р<0,05). В 2-й групі рівні VEGF-A були нижче, ніж в 1-й групі, що, ймовірно, пов'язано з протективним ефектом метформіну. Аналіз впливу ступеня гіпофункції щитовидної залози на ЕД виявив значне збільшення рівнів VEGF-A в підгрупі TSH> 6,0 мкМ / мл (352,55 ± 17,64 пг / мл і 461,74 ± 20,13 пг / мл відповідно, р <0,05). Висновки. Гормональні порушення сприяють погіршенню ендотеліальної дисфункції у пацієнтів з артеріальною гіпертензією та супутніми ендокринопатіями - цукровим діабетом 2 типу та субклінічним гіпотиреозом. Навіть незначне зниження функції щитовидної залози призводить до прогресування ендотеліальної дисфункції. Ключові слова:  гіпертензія, цукровий діабет 2 тип, субклінічний гіпотиреоз, ендотеліальна дисфункція    Резюме. ВЛИЯНИЕ ГОРМОНАЛЬНЫХ НАРУШЕНИЙ НА ЭНДОТЕЛИАЛЬНУЮ ДИСФУНКЦИЮ У ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ И КОМОРБИДНЫМИ ЭНДОКРИНОПАТИЯМИ Беловол О.М., Немцова В.Д., Ильченко И.А., Златкина В.В. Цель: исследовать влияние гормональных изменений на эндотелиальную дисфункцию (ЭД) у пациентов с коморбидным течением артериальной гипертензии (АГ), сахарного диабета 2 типа (СД2Т) и субклинического гипотиреоза (СГТ). Материалы и методы: 183 пациента с АГ IIстадии были разделены на 3 группы: 1-я группа (n = 50) - с изолированной АГ (группа сравнения); Группа 2 (n = 63) - с сочетанным течением АГ и СД2Т; Группа 3 (n = 70) - комбинированное течение АГ, СД2Т и СГТ. Изучали уровни артериального давления,  показатели  углеводного, липидного и тиреоидного обмена, концентрацию инсулина в плазме, индекс инсулинорезистентности (ИР)- HOMA-IR, уровни васкулоэндотелиального фактора роста(VEGF-A) в плазме. Результаты. Степень дислипидемии во 2-й группе была более выраженной, чем в 1-й.  Присоединение СГТ сопровождалось тенденцией к увеличению всех атерогенных фракций липидов. ИР наблюдалась во всех группах пациентов и была достоверно больше, чем в контрольной группе (р<0,05). Выявлено достоверное повышение уровней VEGF-A во всех группах пациентов по сравнению с контролем (р <0,05). Во 2-й группе уровни VEGF-A были ниже, чем в 1-й группе, что, вероятно, связано с протективным эффектом метформина. Анализ влияния степени дисфункции щитовидной железы на ЭД выявил значительное увеличение уровней VEGF-A в подгруппе TSH> 6,0 мкМ/мл (352,55 ± 17,64 пг / мл и 461,74 ± 20,13 пг / мл соответственно, р<0,05). Заключение. Гормональные нарушения способствуют ухудшению эндотелиальной дисфункции у пациентов с артериальной гипертензией и сопутствующими эндокринопатиями - сахарным диабетом 2 типа и субклиническим гипотиреозом. Даже незначительное снижение функции щитовидной железы приводит к прогрессированию эндотелиальной дисфункции. Ключевые слова: гипертензия, сахарный диабет 2 тип, субклинический гипотиреоз, эндотелиальная дисфункция     


HYPERTENSION ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 5-10
Author(s):  
I.I. Topchiy ◽  
O.N. Kirienko ◽  
P.S. Semyonovykh ◽  
D.O. Kirienko ◽  
O.I. Tsygankov ◽  
...  

Currently, diabetes mellitus (DM) is a complex global problem, which is increasing every year. So, in 2019, diabetes mellitus was detected in 463 million adults (from 20 to 79 years old) in the world. And the main cause of death in patients with diabetes mellitus is cardiovascular complications. The study was aimed investigate the features of functional and structural changes in the heart in patients with type 2 diabetes mellitus and nephropathy. A total of 98 patients with type 2 diabetes mellitus were examined, out of which 78 patients had diabetic nephropathy (DN) of varying severity. The control group consisted of 20 healthy patients. After a clinical examination, depending on the state of renal function, all patients were divided into the following groups: group I — patients with type 2 diabetes mellitus without signs of nephropathy (n = 36), group II — patients with type 2 diabetes mellitus with normal glomerular filtration rate (GFR) and albuminuria (n = 33), group III — patients with type 2 diabetes mellitus with decreased GFR and albuminuria (n = 29). To study changes in hemodynamics and structural parameters of the heart, patients underwent transthoracic echocardiography on an ULTIMA PA ultrasound machine (Radmir, Ukraine) using a sectoral phased transducer with a frequency range of 2–3 MHz according to the standard technique based on the recommendations of the American Echocardiographic Society. To determine indexing indicators, the patients underwent anthropometric measurements. Patients with DN and albuminuria and decreased GFR showed an increase in the linear dimensions of the heart in comparison with controls and patients without signs of nephropathy. With DN, patients have a significant increase in left ventricular mass and a significant increase in the detection rate of left ventricular hypertrophy up to 91.3 % in patients with albuminuria and preserved renal function and up to 100 % with a decrease in GFR.


2021 ◽  
Vol 90 (1) ◽  
pp. 44-51
Author(s):  
I.I. Topchii ◽  
P.S. Semenovykh ◽  
O.M. Kirienko ◽  
D.O. Kirienko ◽  
O.I. Tsygankov ◽  
...  

Currently, diabetes mellitus is a complex global problem, which is increasing every year. So in 2019, diabetes in the world was detected in 463 million adults (from 20 to 79 years old). And the main cause of death in patients with diabetes mellitus is cardiovascular complications. The features of functional and structural changes in the heart were studied in patients with type 2 diabetes mellitus and nephropathy. A total of 75 patients with type 2 diabetes mellitus were examined, of which 50 patients had diabetic nephropathy of varying severity. The control group consisted of 20 healthy individuals. The control group consisted of 20 practically healthy patients. After a clinical examination, depending on the state of renal function, all patients were divided into the following groups: group I consisted of 25 patients with type 2 diabetes mellitus without signs of nephropathy; group II consisted of 26 patients with type 2 diabetes mellitus with normal glomerular filtration rate and albuminuria; group III consisted of 24 patients with type 2 diabetes mellitus with decreased glomerular filtration rate and albuminuria. To study changes in hemodynamics and structural parameters of the heart, patients underwent transthoracic echocardiography on an ULTIMA PA ultrasound machine (Radmir, Ukraine) using a sectoral phased transducer with a frequency range of 2–3 MHz according to the standard technique according to the recommendations of the American Echocardiographic Society. Indicators the patients underwent anthropometric measurements. Patients with diabetic nephropathy and albuminuria and decreased glomerular filtration rate showed an increase in the linear dimensions of the heart in comparison with controls and patients without signs of nephropathy. With diabetic nephropathy patients have a significant increase in left ventricular myocardial mass and a significant increase in the detection rate of left ventricular hypertrophy up to 91.3 % in patients with albuminuria and preserved renal function and up to 100.0 % with a decrease in glomerular filtration rate. Keywords: diabetes mellitus, hypertonic disease, diabetic nephropathy, heart remodeling, chronic kidney disease.


2021 ◽  
Vol 2 (3) ◽  
pp. 56-61
Author(s):  
E. S. Krutikov ◽  
V. A. Tsvetkov ◽  
S. I. Chistyakova ◽  
R. O. Akaev

Objective: of article was to study the level of cerebral natriuretic peptide in patients with type 2 diabetes mellitus with diastolic dysfunction and with various types of left ventricular remodeling. Materials and methods: 256 patients with type 2 diabetes mellitus (DM) who had moderate arterial hypertension (AH) and no clinical signs of chronic heart failure were examined. The control group consisted of 30 practically healthy persons, comparable in age and sex with the examined patients. All patients were determined the concentration of brain natriuretic peptide (BNP) in blood plasma. The structural and functional parameters of the heart were determined by echocardiography in B- and M-modes according to the standard technique. Results: in patients with type 2 diabetes and diastolic dysfunction, the BNP concentration was 156 (84; 228) pg / ml, in patients without diastolic filling disorders — 24 (12; 38) pg / ml. The highest BNP values were found in the subgroup of patients with a restrictive type of transmitral flow. Also, BNP values were higher in the group of patients with concentric and eccentric left ventricular (LV) hypertrophy. Conclusion: in all patients with type 2 diabetes and concomitant moderate hypertension, even in the absence of clinical signs of CHF, there is an increase in the BNP level compared to the control group. The highest BNP values were observed in patients with severe diastolic dysfunction and unfavorable variants of LV remodeling.


Author(s):  
U. P. Hevko ◽  
M. I. Marushchak

Background. The course of type 2 diabetes mellitus (T2DM), obesity and chronic pancreatitis (CP) in most cases is not isolated, so it requires broadening the knowledge about the pathogenetic links at their combined course. Despite significant advances in genome research, most of the genetic factors that cause development of T2DM are still unclear. Objective. The aim of the study was to establish the prevalence of IRS1 gene polymorphism in the patients with T2DM as well as obesity and CP. Methods. The study involved 34 patients with T2DM who were hospitalized in the endocrinology department of Ternopil University Hospital in 2019-2020 and 10 apparently healthy patients. Analysis of IRS1 gene polymorphism (SNP in the promoter region - rs2943640; gene localization 2q36.3) was performed on the basis of polymerase chain reaction data using specific primers. Results. It was found that the frequencies of the genotype responsible for C/A polymorphism of IRS1 gene in T2DM, T2DM with obesity and in the combined course of T2DM with obesity and CP did not deviate significantly from the Hardy-Weinberg equilibrium (p>0.05). The patients with combined course of T2DM, obesity and chronic pancreatitis experienced a probable influence of genotypes C/C and C/A of IRS1 gene on the development of the studied comorbidity (p<0.05), which is confirmed by a probable difference in the dominant model of IRS1 gene inheritance only when T2DM was combined with obesity and CP compared to the control group (p<0.001). Conclusions. The presence of the C allele in both homozygous and heterozygous states may increase the risk of T2DM comorbidity, obesity and CP in the population of Ternopil region.


2018 ◽  
Vol 26 (1) ◽  
pp. 86-95
Author(s):  
D. K. Muhabbatov ◽  
M. K. Gulov ◽  
B. M. Hamroev

Aim of work: to study the incidence of components of metabolic syndrome in patients with anal fistulae, to analyze combinations of different components of metabolic syndrome and types of pararectal fistulae. Materials and Methods. A clinical examination of 508 patients (85.2% – men; 21.5% at the age of 20-39 years, 43.9% – 40-59 years, 34.6% – ≥60 years) with anal fistulae (of them 48.0% were transsphincteric and 29.3% – extrasphincteric fistulae) who underwent treatment in the department of coloproctology of municipal clinical hospital №5 of Dushanbe in the period from 2010 to 2015, was conducted with the aim of identification of components of metabolic syndrome. Results. In 282 patients (55.5% of the total number of patients with anal fistulae, 90.8% of them being men) components of metabolic syndrome were identified: obesity – in 229 patients (45.1% of the total patients with anal fistulae), arterial hypertension – in 115 patients (22,6%), type 2 diabetes mellitus – in 58 patients (11.4%), IHD – in 8 patients (1.6%). In the presence of components of metabolic syndrome the recurrent forms of fistulae were recorded in 16.3% of cases (in the absence – in 12.8% of cases), and complicated forms – extrasphincteric (29.3%) predominated over intrasphincteric forms (22.7%); in control group the proportion of the mentioned forms was 24.8% and 29.2%, respectively. Transsphincteric forms were most common in both groups (48.0% and 46.0%). Conclusions. Components of metabolic syndrome in different combinations were identified in more than half (55.5%) the patients with anal fistulae (obesity – 45.1%, arterial hypertension – 22.6%, 2 type diabetes mellitus – 11.4%, IHD – 1.6%). A tendency was recorded to a more common recurrence of anal fistulae and to a more complicated forms of anal fistulae in patients with components of metabolic syndrome.


2018 ◽  
Vol 26 (1) ◽  
pp. 86-95 ◽  
Author(s):  
D. K. Muhabbatov ◽  
M. K. Gulov ◽  
B. M. Hamroev

Aim of work: to study the incidence of components of metabolic syndrome in patients with anal fistulae, to analyze combinations of different components of metabolic syndrome and types of pararectal fistulae. Materials and Methods. A clinical examination of 508 patients (85.2% – men; 21.5% at the age of 20-39 years, 43.9% – 40-59 years, 34.6% – ≥60 years) with anal fistulae (of them 48.0% were transsphincteric and 29.3% – extrasphincteric fistulae) who underwent treatment in the department of coloproctology of municipal clinical hospital №5 of Dushanbe in the period from 2010 to 2015, was conducted with the aim of identification of components of metabolic syndrome. Results. In 282 patients (55.5% of the total number of patients with anal fistulae, 90.8% of them being men) components of metabolic syndrome were identified: obesity – in 229 patients (45.1% of the total patients with anal fistulae), arterial hypertension – in 115 patients (22,6%), type 2 diabetes mellitus – in 58 patients (11.4%), IHD – in 8 patients (1.6%). In the presence of components of metabolic syndrome the recurrent forms of fistulae were recorded in 16.3% of cases (in the absence – in 12.8% of cases), and complicated forms – extrasphincteric (29.3%) predominated over intrasphincteric forms (22.7%); in control group the proportion of the mentioned forms was 24.8% and 29.2%, respectively. Transsphincteric forms were most common in both groups (48.0% and 46.0%). Conclusions. Components of metabolic syndrome in different combinations were identified in more than half (55.5%) the patients with anal fistulae (obesity – 45.1%, arterial hypertension – 22.6%, 2 type diabetes mellitus – 11.4%, IHD – 1.6%). A tendency was recorded to a more common recurrence of anal fistulae and to a more complicated forms of anal fistulae in patients with components of metabolic syndrome.


Author(s):  
Shah Namrata Vinubhai ◽  
Pardeep Agarwal ◽  
Bushra Fiza ◽  
Ramkishan Jat

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.


2018 ◽  
Vol 4 (2) ◽  
pp. 58-62
Author(s):  
Roksana Yeasmin ◽  
MA Muttalib ◽  
Kazi Nazneen Sultana ◽  
Nizamul Hoque Bhuiyan ◽  
Md Jamil Hasan Karami ◽  
...  

Background: Type 2 diabetes mellitus is a chronic disease characterized by relative or absolute deficiency of insulin, resulting in glucose intolerance.Objectives: The present study was planned to see the associations of serum uric acid with positive Rheumatoid factor in type 2 male diabetes mellitus patients. Methodology: This case control study was carried out at the department of Biochemistry at Ibrahim Medical College, Dhaka, Bangladesh. The duration of the study was from June 2015 to June 2016 for a period of one year. In this present study, male patients with type 2 diabetes mellitus were taken as case group and age and sex matched healthy male were taken as control group. Rheumatoid factor was measured from the blood of all case and control group respondents. Others blood para meters were also measured for the correlation with the diabetes mellitus patients.Results: In this present study, 110 male patients presented with type 2 diabetes mellitus were recruited as case and age and sex matched healthy male were recruited as control. More rheumatoid factor positive in type 2 DM male patients with the uric acid range between 6.5 to 9.5 mg/dL. The number of patients was 5 out of total 9 rheumatoid factor positive cases. In this study serum uric acid was significantly correlated with rheumatoid factor in type 2 male diabetic patients. Rheumatoid factor positive cases were taking insulin among 9 and it was statistically significantly associated (p<0.001). Conclusion: In this study serum uric acid is significantly associated with positive rheumatoid factor in type 2 male diabetic patients.Journal of Current and Advance Medical Research 2017;4(2):58-62


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yuki Yamauchi ◽  
Hidekazu Tanaka ◽  
Shun Yokota ◽  
Yasuhide Mochizuki ◽  
Yuko Yoshigai ◽  
...  

Abstract Background Left ventricular (LV) longitudinal myocardial dysfunction is considered a marker of preclinical LV dysfunction in patients with type 2 diabetes mellitus (T2DM). High heart rate (HR) is associated with cardiovascular outcomes, but the effect of HR on LV longitudinal myocardial function in T2DM patients is uncertain. Methods We studied 192 T2DM patients with preserved LV ejection fraction (LVEF), and 81 age-, sex-, and LVEF-matched healthy volunteers. HR was measured as the average HR during echocardiography, and high HR was defined as resting HR ≥ 70 beats/minute. LV longitudinal myocardial function was assessed as global longitudinal strain (GLS). The predefined cutoff for subclinical LV dysfunction was set at GLS < 18%. Results GLS in T2DM patients with high HR was significantly lower than that in T2DM patients with low HR (16.3% ± 4.2% vs. 17.8% ± 2.8%; P = 0.03), whereas GLS in normal subjects with high and low HR was similar (20.3 ± 1.7% vs. 20.3 ± 2.0%; P = 0.99). Multivariable logistic regression analysis showed that high HR (odds ratio: 1.04; 95% confidence interval: 1.01–1.07; P = 0.01) was independently associated with GLS < 18% in T2DM patients as well as HbA1c, T2DM duration, LVEF, body mass index, and mitral inflow E and mitral e’ annular velocity ratio. One sequential logistic model evaluating the associations between GLS < 18% and clinical variables in T2DM patients showed an improvement with the addition of LVEF and E/e’ (P < 0.001) and a further improvement with the addition of high HR (P < 0.001). Conclusion Compared with normal subjects, resting HR was associated with LV longitudinal myocardial function in asymptomatic T2DM patients with preserved LVEF. Our findings provide new insights on the management of T2DM patients.


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