Bućan Kajo, Bojić Lovro, Fabijanić Damir, Galetović Davor, Čapkun Vesna, Utrobičić Dobrila Karlica, Bućan Ivona
Acta Clin Croat. 2014 Dec;53(4):383-9.
Vascular endothelial dysfunction is a basic etiologic factor for the development of late clinical complications in patients with diabetes mellitus type 1, such as diabetic retinopathy, diabetic nephropathy (which is characterized at the very beginning by microalbuminuria), and left ventricular cardiac dysfunction. The aims of this study were to determine the prevalence of asymptomatic left ventricular systolic dysfunction in patients with diabetes mellitus type 1 and with or without diabetic retinopathy and microalbuminuria, and to correlate the duration of diabetes with the dynamics of diabetic retinopathy, microalbuminuria and asymptomatic left ventricular dysfunction development in these patients. One-hundred and twenty selected patients with diabetes mellitus type 1 were examined by ophthalmologist and cardiologist. All patients underwent ergometric testing and two-dimensional (2-D) echocardiography with pulsed Doppler. Patients were divided into three groups according to their fundus findings and microalbuminuria: (1) patients without diabetic retinopathy and without microalbuminuria (n = 40); (2) patients with diabetic retinopathy without microalbuminuria (n = 40); and (3) patients with diabetic retinopathy and microalbuminuria (n = 40). All three groups of patients with diabetes mellitus type 1 (with low cardiovascular risk, regulated blood sugar, and without diabetic neuropathy) had echocardiographic values in the normal range. We found no statistically significant correlation between the duration of diabetes mellitus type 1 and echocardiographic values.
血管内皮功能障碍是1型糖尿病患者发生晚期临床并发症的基本病因,如糖尿病视网膜病变、糖尿病肾病(最初表现为微量白蛋白尿)和左心室心脏功能障碍。本研究的目的是确定1型糖尿病患者有无糖尿病视网膜病变和微量白蛋白尿时无症状左心室收缩功能障碍的患病率,并将糖尿病病程与这些患者糖尿病视网膜病变、微量白蛋白尿和无症状左心室功能障碍发展的动态变化相关联。120例入选的1型糖尿病患者接受了眼科医生和心脏病专家的检查。所有患者均进行了运动试验和二维(2-D)超声心动图检查及脉冲多普勒检查。根据眼底检查结果和微量白蛋白尿情况将患者分为三组:(1)无糖尿病视网膜病变且无微量白蛋白尿的患者(n = 40);(2)有糖尿病视网膜病变但无微量白蛋白尿的患者(n = 40);(3)有糖尿病视网膜病变且有微量白蛋白尿的患者(n = 40)。所有三组1型糖尿病患者(心血管风险低、血糖得到控制且无糖尿病神经病变)的超声心动图值均在正常范围内。我们发现1型糖尿病病程与超声心动图值之间无统计学显著相关性。