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新诊断的 2 型糖尿病伴或不伴高血压患者的超声心动图改变。

Echocardiographic Changes in Newly Diagnosed Type 2 Diabetes Mellitus Patients with and without Hypertension.

机构信息

Department of Endocrinology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China (mainland).

Department of Cardiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China (mainland).

出版信息

Med Sci Monit. 2020 Jan 26;26:e918972. doi: 10.12659/MSM.918972.

Abstract

BACKGROUND Whether type 2 diabetes mellitus (T2DM) is independently associated with structural heart abnormalities is controversial because of confounders associated with T2DM. This study aimed to investigate echocardiographic features in patients with newly diagnosed T2DM, exploring changes in cardiac structure and function. MATERIAL AND METHODS This was a retrospective study of new T2DM cases treated at the Second People's Hospital Affiliated to Nanjing Medical University (Changzhou) in 2014-2016. In all, 128 T2DM cases were included (62 hypertensive and 66 non-hypertensive individuals). Controls were selected among individuals who underwent examination at the same department/period. Interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDD), posterior left ventricular wall thickness (PWTD), left ventricle mass (LVM), end-diastolic thickness of left ventricular posterior wall (Dd), aortic root diameter, left atrial diameter (LAd), left atrial diameter fraction-shortening values, and left ventricular ejection fraction (LVEF) were determined routinely. RESULTS IVST, LVEDD, PWTD, Dd, LAd, and left atrial diameter fraction-shortening values were larger in patients with T2DM (all P<0.05 vs. controls). LVM was higher in T2DM patients (median, 57.12 vs. 54.77 g, P=0.001). There were no differences in aortic root diameter and EF (both P>0.05). Multivariable analysis showed that IVST (OR=1.33, 95% CI: 1.01-1.76, P=0.04), LAd (OR=1.16, 95% CI: 1.07-1.25, P<0.001), TGs (OR=1.34, 95% CI: 1.09-1.63, P=0.005), and HDL (OR=1.46, 95% CI: 1.02-2.08, P=0.04) were independently associated with hypertension in patients with T2DM. CONCLUSIONS Patients with newly diagnosed T2DM already display structural heart abnormalities. LAd and IVST are independently associated with hypertension in these patients, probably contributing to increased cardiovascular risk.

摘要

背景

由于 2 型糖尿病(T2DM)与 T2DM 相关的混杂因素相关,因此 T2DM 是否与结构性心脏异常独立相关仍存在争议。本研究旨在探讨新诊断为 T2DM 患者的超声心动图特征,探索心脏结构和功能的变化。

材料和方法

这是一项回顾性研究,纳入了 2014 年至 2016 年在南京医科大学第二附属医院(常州)治疗的新诊断为 T2DM 的 128 例患者(62 例高血压患者和 66 例非高血压患者)。对照组是在同一科室/同期接受检查的个体中选择的。常规测定室间隔厚度(IVST)、左心室舒张末期直径(LVEDD)、左心室后壁厚度(PWTD)、左心室质量(LVM)、左心室后壁舒张末期厚度(Dd)、主动脉根部直径、左心房直径(LAd)、左心房短轴缩短率和左心室射血分数(LVEF)。

结果

T2DM 患者的 IVST、LVEDD、PWTD、Dd、LAd 和左心房短轴缩短率均较大(均 P<0.05 与对照组相比)。T2DM 患者的 LVM 较高(中位数为 57.12 与 54.77 g,P=0.001)。主动脉根部直径和 EF 无差异(均 P>0.05)。多变量分析显示,IVST(OR=1.33,95%CI:1.01-1.76,P=0.04)、LAd(OR=1.16,95%CI:1.07-1.25,P<0.001)、TGs(OR=1.34,95%CI:1.09-1.63,P=0.005)和 HDL(OR=1.46,95%CI:1.02-2.08,P=0.04)与 T2DM 患者的高血压独立相关。

结论

新诊断为 T2DM 的患者已经存在结构性心脏异常。LAd 和 IVST 与这些患者的高血压独立相关,可能导致心血管风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bd0/7001517/bd15cabb0e69/medscimonit-26-e918972-g001.jpg

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