Key result
Each 1 kg/m2 increase in body mass index was associated with a 1.11 times higher odds of left ventricular diastolic dysfunction among ambulatory adults with diabetes mellitus.
Why the study?
Left ventricular diastolic dysfunction is a recognized complication of diabetes mellitus that precedes and is a risk factor for heart failure, but its prevalence and association with body mass index in rural Uganda remained to be determined.
Does increased body mass index associate with left ventricular diastolic dysfunction in ambulatory adults with diabetes mellitus?
Cross-Sectional (n=195)
No
Does increased body mass index associate with left ventricular diastolic dysfunction in ambulatory adults with diabetes mellitus?
Odds Ratio: 1.11 (95% CI 1–1.25)
p-value: p=0.04
Left ventricular diastolic dysfunction is highly prevalent among ambulatory adults with diabetes in rural Uganda and is positively associated with increasing BMI, particularly in older and hypertensive individuals.
Supports BMI assessment for diastolic dysfunction risk in diabetes; hypothesis-generating and requires prospective validation before practice change.
Background Left ventricular diastolic dysfunction (LVDD) is a recognized complication of diabetes mellitus that precedes and is a risk factor for heart failure. We aimed to determine the prevalence of LVDD and its association with body mass index in ambulatory adults with diabetes mellitus in rural Uganda. Methods We conducted a cross-sectional study, over 5 months, to enroll 195 ambulatory Ugandan adults living with diabetes mellitus for at least five years at Mbarara Regional Referral Hospital. We collected demographic, and clinical data and measured body mass index (BMI). Echocardiography was performed to determine LVDD by assessing the mitral inflow ventricular filling velocities (E/A and E/è ratios), tricuspid regurgitant jet peak velocity, and left atrium maximum volume index. We used logistic regression to estimate the odds ratio for the association of LVDD with BMI and evaluated the variation of associations by age and hypertension status. Results Of the 195 participants, 141 (72.31%) were female, the mean age was 62 [standard deviation, 11.50] years, and the median duration of diabetes diagnosis was 10 [interquartile range, 7, 15] years. Eighty-six percent (n = 168) had LVDD with the majority (n = 127, 65.1%) of participants in the grade 1 category of LVDD. In the adjusted model, the odds of LVDD for each 1 kg/m 2 increase in BMI was 1.11 [95% confidence interval 1.00, 1.25, p = 0.04]. The adjusted odds of LVDD among individuals aged ≥ 50 years with BMI ≥ 25 kg/m 2 was 13.82 times the odds of LVDD in individuals aged < 50 years with BMI < 25 kg/m 2 . Conclusion LVDD is prevalent and positively associated with BMI among ambulatory Ugandan adults living with diabetes mellitus for at least five years. The association was higher for older overweight/obese than younger individuals with normal weight. Future studies should focus on the effect of weight loss on LVDD as a possible target for the prevention of heart failure.
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Lumori et al. (2022) conducted a cross-sectional in Diabetes mellitus (n=195). Body mass index vs. Lower body mass index was evaluated on Left ventricular diastolic dysfunction (LVDD) (OR 1.11, 95% CI 1.00-1.25, p=0.04). Each 1 kg/m2 increase in body mass index was associated with a 1.11 times higher odds of left ventricular diastolic dysfunction among ambulatory adults with diabetes mellitus.
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