Key result
Higher HbA1c (OR 1.27; 95% CI 1.09-1.49), age, and metformin use were independent predictors of subclinical left ventricular dysfunction, which was present in 59.9% of type 2 diabetes patients.
Cross-Sectional (n=751)
Yes
Odds Ratio: 1.27 (95% CI 1.09–1.49)
In asymptomatic patients with type 2 diabetes, subclinical left ventricular dysfunction is highly prevalent (59.9%) and is associated with age, poor glycemic control, insulin resistance traits, and certain medications.
BACKGROUND: Better knowledge of prevalence and early-stage determinants of subclinical left ventricular dysfunction (LVD) in type 2 diabetes would be useful to design prevention strategies. The objective of the LVD in Diabetes (DYDA) study was to assess these points in patients without established cardiac disease. METHOD: Baseline clinical, ECG, laboratory and echocardiographic data from 751 patients (61 ± 7 years, 59% hypertensive) recruited by 37 Italian diabetes clinics were analysed. Clinical history, life habits, laboratory data (NT-proBNP, HsCRP, HbA1c, serum glucose, lipids and creatinine, liver enzymes, microalbuminuria, glomerular filtrate) and data on microvascular complications and drug therapy were collected. RESULTS: LVD was present in 59.9% of patients. Age (OR 1.05, 95% CI [1.02-1.07]), HbA1c (OR 1.27, 95% CI [1.09-1.49]), triglycerides (OR 1.003, 95% CI [1.001-1.006]), treatment with metformin (OR 1.62, 95% CI [1.09-2.40]) and doxazosine (OR 2.48, 95% CI [1.10-5.55]) were independent predictors of LVD. Glitazones were associated with reduced risk of diastolic dysfunction (OR 0.44, 95% CI [0.22-0.87]) whereas waist circumference and metformin were adversely associated with systolic dysfunction (OR 1.02, 95% CI [1.01-1.04] and 1.57, 95% CI [1.01-2.43], respectively). CONCLUSION: In asymptomatic and fairly controlled diabetic patients, age, worse HbA1c, traits of insulin resistance, such as visceral adiposity and triglycerides or treatment with metformin, and use of doxazosin indicate greater risk of LVD. Glitazones, at this stage, seem to be associated with better diastolic performance.
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Giorda et al. (2011) conducted a cross-sectional in type 2 diabetes (n=751). HbA1c was evaluated on left ventricular dysfunction (LVD) (OR 1.27, 95% CI 1.09-1.49). Higher HbA1c (OR 1.27; 95% CI 1.09-1.49), age, and metformin use were independent predictors of subclinical left ventricular dysfunction, which was present in 59.9% of type 2 diabetes patients.
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