Key result
Microalbuminuria in T2D linked to ~18% lower E/A ratio, signaling worse LV diastolic function.
Why the study?
Albuminuria in type 2 diabetes patients predicts dysfunction in other organ systems and increases cardiovascular morbidity and mortality, but its association with left ventricular dysfunction needs assessment.
Is microalbuminuria associated with left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus?
Cross-Sectional (n=100)
No
Is microalbuminuria associated with left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus?
Microalbuminuria is associated with an increased likelihood of left ventricular diastolic dysfunction in patients with type 2 diabetes, suggesting a need for regular echocardiographic evaluation in this population.
Answers are grounded in this paper and cite their sources.
Microalbuminuria may mark higher LVDD risk in T2DM; leaves open whether it warrants routine echocardiography.
Background The prevalence of diabetes mellitus is on rising trend in developing countries like India. In type 2 diabetes patients, albuminuria has been shown to predict development of dysfunction in other organ systems such as kidneys, nervous system, and retina and increase risk of cardiovascular (CV) morbidity and mortality. In this study, we plan to assess association of microalbuminuria with left ventricular dysfunction in type 2 diabetes mellitus. Results This cross-sectional study was conducted among 100 type 2 diabetes mellitus patients attending a tertiary care hospital in Gujarat, Western India. Based on urine albumin excretion status, they were divided in two groups of 50 each—normoalbuminuric and microalbuminuric patients. The mean FBS, PPBS, and HbA1c level was significantly lower in normoalbuminuric group compared to microalbuminuric group. There was an increase in cholesterol, triglyceride, VLDL, and LDL levels and decrease in HDL levels in microalbuminuric group as compared to normoalbuminuric group. Multivariate logistic regression analysis revealed that increase in age and a decrease in E/A ratio in patients with microalbuminuria was significantly associated with left ventricular diastolic dysfunction (LVDD). Conclusion The presence of microalbuminuria is associated with increased likelihood of LVDD in type 2 diabetes patients. Increase in age and decrease in E/A ratio show direct and independent association with LVDD in normotensive diabetic patients with microalbuminuria. Therefore, diabetes patients who have microalbuminuria should be regularly (or more frequently) evaluated for development of LVDD using Echocardiography. This can allow early identification of myocardial diastolic dysfunction.
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Mehta et al. (2021) conducted a cross-sectional in Type 2 diabetes mellitus (n=100). Microalbuminuria vs. Normoalbuminuria was evaluated on E/A ratio (marker of left ventricular diastolic dysfunction) (p=< 0.05). Microalbuminuria in patients with type 2 diabetes mellitus was associated with significantly worse left ventricular diastolic function, indicated by a lower E/A ratio compared to normoalbuminuric patients (0.81 vs 0.99, p<0.05).
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