Association of LDL Cholesterol and hs-CRP with Subtypes of Heart Failure in Type 2 Diabetes Mellitus Patients: A Cross-sectional Study

Introduction: Heart Failure (HF) in patients with Type 2 Diabetes Mellitus (T2DM) is classified based on Ejection Fraction (EF) into HF with reduced EF (HFrEF) and HF with preserved EF (HFpEF). Low-Density Lipoprotein Cholesterol (LDL-C), a marker of dyslipidaemia, and high-sensitivity C-Reactive Protein (hsCRP), an inflammatory biomarker, are recognised for their roles in contributing to cardiovascular diseases and HF progression in T2DM patients. Aim: To explore the clinical and aetiological characteristics of HF in T2DM patients and to analyse the association between LDL-C and hs-CRP levels with different HF subtypes. Materials and Methods: The present cross-sectional study was conducted from October 2023 to March 2025 at a tertiary care hospital in Western Maharashtra, India. The study included 100 patients over 18 years of age with Type 2 Diabetes and HF, in whom LDL-C and hs-CRP levels were elevated. LDL-C was calculated using the Friedewald formula, and hs-CRP was measured using the nephelometry method. The Statistical Package for Social Sciences (SPSS) statistics package version 20 was used for statistical analysis. The χ2 test, t-test, and nonparametric tests were employed, with statistical significance acknowledged at the p-value <0.05 level. Results: The study included 100 T2DM patients with HF. hsCRP levels were elevated in both the HFrEF and HFpEF groups; however, no significant difference was found between them (p-value=0.698). LDL-C showed no statistically significant association with HF type (p-value=0.931). HbA1c was higher in the HFrEF group (9.84±1.6) compared to the HFpEF group (8.73±1.4), with statistical significance (p-value=0.001). Conclusion: LDL-C and hs-CRP levels showed no significant association with HF subtypes, although trends suggested an inverse correlation with EF that was not statistically significant. A significant inverse relationship between HbA1c and EF highlighted the impact of poor glycaemic control on cardiac function. These findings support the need for comprehensive metabolic and inflammatory profiling in diabetic HF patients.