1417-P: Sex Differences in NT-proBNP and Subclinical HFpEF in Type 1 and Type 2 Diabetes

Introduction and Objective: Heart failure with preserved ejection fraction (HFpEF) is a major cardiometabolic complication of diabetes mellitus (DM), often remaining subclinical. Natriuretic peptides, particularly NT-proBNP, serve as early biomarkers of myocardial dysfunction. However, comparative data on NT-proBNP patterns between type 1 (T1DM) and type 2 diabetes (T2DM), especially regarding sex-specific differences, remain limited. Methods: This cross-sectional study included 80 hospitalized patients with stable diabetes (23 T1DM, 57 T2DM). Serum NT-proBNP was measured, with levels >125 pg/mL considered elevated per ESC criteria. Group differences in NT-proBNP prevalence were assessed using Pearson’s χ² test, with additional sex-specific analysis. Results: Elevated NT-proBNP (>125 pg/mL) was detected in all patients with T1DM (100%) and in 81% of those with T2DM, showing a strong trend toward higher prevalence in T1DM (χ² = 3.65, p > 0.05). Mean NT-proBNP levels exceeded diagnostic thresholds in both groups, with all T1DM patients above the cut-off, while a subset of T2DM patients remained below it, indicating heterogeneity of subclinical cardiac involvement. Significant sex differences were observed: women predominated in the T1DM group (79%), while women comprised 47% of the T2DM group, and elevated NT-proBNP was more frequent in women, whereas men were overrepresented among T2DM patients with normal values (χ² = 6.13, p < 0.05). No patients had clinically overt heart failure, consistent with subclinical HFpEF-like dysfunction. Conclusion: NT-proBNP is frequently elevated in both T1DM and T2DM in the absence of overt heart failure, indicating a substantial burden of subclinical HFpEF. T1DM shows a particularly high prevalence of NT-proBNP elevation, while women demonstrate more pronounced NT-proBNP increases across diabetes types, underscoring the importance of sex-specific interpretation. Incorporating NT-proBNP into cardiometabolic screening with attention to female sex may enhance early HFpEF risk stratification in diabetes. Disclosure A. Sokolova: None.