Key result
Plasma cardiotrophin-1 (CT-1) was the best predictor of left ventricular systolic dysfunction (sensitivity 69%), while brain natriuretic peptide (BNP) best predicted diastolic dysfunction (sensitivity 82%) in children with type 1 diabetes mellitus.
Why the study?
The study aimed to determine the best cardiac biomarker for predicting diabetic cardiomyopathy and evaluating LV and RV function impairment in children with type 1 diabetes mellitus.
Which cardiac biomarkers best predict left and right ventricular dysfunction in children with type 1 diabetes mellitus?
Case-Control (n=110)
No
Which cardiac biomarkers best predict left and right ventricular dysfunction in children with type 1 diabetes mellitus?
Effect estimate: AUC 0.7632
p-value: p=0.0042
CT-1 and BNP are promising biomarkers for the early detection of systolic and diastolic ventricular dysfunction, respectively, in children with type 1 diabetes mellitus.
May support biomarker screening for ventricular dysfunction in pediatric T1DM; leaves open prospective validation before clinical adoption.
BACKGROUND: Evaluation of certain biomarkers could be used to predict left ventricular (LV) and right ventricular (RV) function impairment in children with type 1 diabetes mellitus. The aim of this study was to determine the best cardiac biomarker for prediction of diabetic cardiomyopathy. METHODOLOGY: This study was designed as case-control study. A total of 55 children with type 1 diabetes mellitus (group/G1) and 55 healthy controls (G2) were subjected to echocardiography including 3D-Speckle Tracking Echocardiography and tissue Doppler imaging for assessment of RV and LV systolic and diastolic functions. As well as HbA1c, troponin I, brain natriuretic peptide (BNP), plasma cardiotrophin (CT-1), activin-A, transforming growth factor-β, and human insulin-like growth factor binding protein-7 (IGFBP-7) measurements. RESULTS: Diabetic patients showed RV and LV systo-diastolic dysfunction compared to controls, the best predictor of LV systolic dysfunction was CT-1 (sensitivity: 69%, while IGFBP-7 was found to be the best predictor of RV systolic dysfunction (sensitivity: 63%). BNP was found to the best predictor of diastolic RV and LV dysfunction (sensitivity: 82% for both). CONCLUSION: CT-1 has proven to be a diagnostic superiority in LV systolic dysfunction whilst BNP continues to prove every day through our study and through many others that it is the chief marker of diastolic dysfunction and HFpEF. This potential accuracy and the increasing availability of BNP in the outpatient setting make it clear that it should be used as a screening test for diabetic patients.
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El-Saiedi et al. (2020) conducted a case-control in Type 1 diabetes mellitus (n=110). Biomarker evaluation (CT-1, BNP, IGFBP-7, TGF-β1, ACV-A) vs. Healthy controls was evaluated on Prediction of left ventricular systolic dysfunction using CT-1 (AUC 0.7632, p=0.0042). Plasma cardiotrophin-1 (CT-1) was the best predictor of left ventricular systolic dysfunction (sensitivity 69%), while brain natriuretic peptide (BNP) best predicted diastolic dysfunction (sensitivity 82%) in children with type 1 diabetes mellitus.
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