Identifying a high-risk CKM syndrome phenotype: association of albuminuria with subclinical hemodynamic alterations via portable noninvasive cardiometer

Q: What are the key findings of this study?

In asymptomatic patients with type 2 diabetes, albuminuria was associated with a significantly lower index of contractility (29.44 vs 34.78, p<0.0001), indicating subclinical hemodynamic alterations.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Type 2 diabetes mellitus (n=274). Intervention: Albuminuria vs. Without albuminuria. Primary outcome: Index of contractility (ICON) (p=<0.0001).

Q: What does this research mean for the field?

In asymptomatic patients with type 2 diabetes, albuminuria is independently associated with subclinical hemodynamic impairment—including reduced cardiac contractility and elevated systemic vascular resistance—and increased all-cause hospitalization. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To assess whether albuminuria is linked to subclinical hemodynamic alterations using portable noninvasive cardiometry in asymptomatic patients with type 2 diabetes mellitus.

Ting‐Chun Chen; Chih-Li Lin; Chien-Yin Kuo; Sing‐Hua Tsou; Shun-Wen Hsiao; Chien‐Ning Huang

doi:10.3389/fendo.2026.1966139

September 29, 2026Frontiers in EndocrinologyOpen Access

Identifying a high-risk CKM syndrome phenotype: association of albuminuria with subclinical hemodynamic alterations via portable noninvasive cardiometer

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Key result

Albuminuria in asymptomatic type 2 diabetes is linked to a ~5-point lower index of contractility.

P<0.0001
n=274

Why the study?

Type 2 diabetes mellitus is closely linked to heart failure, but the association of albuminuria with subclinical hemodynamic alterations is not well characterized.

Does the presence of albuminuria correlate with subclinical hemodynamic alterations in asymptomatic patients with T2DM?

Key Points

To assess whether albuminuria is linked to subclinical hemodynamic alterations using portable noninvasive cardiometry in asymptomatic patients with type 2 diabetes mellitus.
Prospective cohort study of 274 outpatients with type 2 diabetes mellitus without clinically recognized heart failure or coronary artery disease.
Hemodynamic indices, including index of contractility (ICON) and stroke volume, were evaluated via portable noninvasive cardiometry across patients with (n=119) and without (n=155) albuminuria.
Patients with albuminuria showed significantly lower index of contractility (29.44 ± 9.48 vs 34.78 ± 10.18, p<0.0001) and stroke volume (52.61 ± 10.91 vs 55.84 ± 9.80 mL, p=0.0113), alongside higher systemic vascular resistance (median 1908.33 vs 1730.33, p=0.0152).
Albuminuria remained independently associated with lower contractility after multivariable adjustment (parameter estimate -2.67639, p=0.0184), while higher body mass index was also strongly associated with lower contractility (parameter estimate -1.02028, p<0.0001).
All-cause medical hospitalization occurred at a significantly higher rate in patients with albuminuria than in those without albuminuria (39.5% vs 24.5%, p=0.0079).

Study Design

Type

Observational (n=274)

Multicenter

No

Structured PICO

Does the presence of albuminuria correlate with subclinical hemodynamic alterations in asymptomatic patients with T2DM?

P

Population

274 asymptomatic outpatients with type 2 diabetes mellitus, free of clinical heart failure or coronary artery disease, evaluated for subclinical hemodynamic alterations.

E

Exposure

Presence of albuminuria (urine albumin-creatinine ratio [UACR] ≥30 mg/g)

C

Comparator

Absence of albuminuria (urine albumin-creatinine ratio [UACR] <30 mg/g)

O

Outcome

Hemodynamic parameters (including stroke volume and index of contractility) assessed by portable noninvasive cardiometrysurrogate

Main Result

Absolute Event Rate: 29.44% vs 34.78%

p-value: p=<0.0001

In asymptomatic patients with type 2 diabetes mellitus, albuminuria is independently associated with subclinical hemodynamic alterations such as reduced stroke volume and contractility, highlighting its potential utility in early cardiovascular risk assessment.

Limitations

Conducted in a single center with a relatively modest sample size
Echocardiography, including global longitudinal strain (GLS), was not performed concurrently
Incomplete data on baseline use of SGLT2 inhibitors, ACE inhibitors/ARBs, or beta-blockers
Absolute accuracy and precision of electrical cardiometry for contractility indices remain limited
Hospitalization data was exploratory without detailed cause-specific or time-to-event analysis
Single center with a relatively modest sample size
Lack of concurrent echocardiographic data including global longitudinal strain (GLS)
Hospitalization data was exploratory and based on medical admissions without detailed cause-specific or time-to-event analysis

Implication

Albuminuria may flag subclinical hemodynamic impairment in asymptomatic T2DM; leaves open its added value for early risk stratification beyond current markers.

Abstract

Object Type 2 diabetes mellitus (T2DM) is closely linked to heart failure. Methods This prospective study of 274 asymptomatic patients with T2DM without clinical heart failure or coronary artery disease used portable noninvasive cardiometry to assess hemodynamic parameters. Results Patients with albuminuria (n=119) showed significantly lower stroke volume and index of contractility (ICON 29.44 ± 9.48 vs 34.78 ± 10.18, p<0.0001), and higher systemic vascular resistance compared with those without albuminuria (n=155). Albuminuria remained independently associated with reduced ICON after multivariable adjustment that included sex, body mass index, and metabolic parameters. Higher BMI was also strongly associated with lower ICON. Patients with albuminuria also had a higher all-cause medical hospitalization rate (39.5% vs 24.5%) during follow-up. Discussion These findings suggest that T2DM patients with albuminuria may represent a high-risk CKM phenotype characterized by subclinical hemodynamic alterations, supporting further investigation of noninvasive approaches for early cardiovascular risk assessment.

Discussion

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Cite This Study

Chen et al. (2026) conducted an observational in Type 2 diabetes mellitus (n=274). Albuminuria vs. Without albuminuria was evaluated on Index of contractility (ICON) (p=<0.0001). In asymptomatic patients with type 2 diabetes, albuminuria was associated with a significantly lower index of contractility (29.44 vs 34.78, p<0.0001), indicating subclinical hemodynamic alterations.

synapsesocial.com/papers/6ace6db8b52af824ab02bae5 https://doi.org/10.3389/fendo.2026.1966139

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Identifying a high-risk CKM syndrome phenotype: association of albuminuria with subclinical hemodynamic alterations via portable noninvasive cardiometer

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Identifying a high-risk CKM syndrome phenotype: association of albuminuria with subclinical hemodynamic alterations via portable noninvasive cardiometer

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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