Department of Echocardiography and Cardiology, The Third Affiliated Hospital of Soochow University, Chang Zhou, China.
Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Chang Zhou, China.
Clin Cardiol. 2023 Dec;46(12):1578-1587. doi: 10.1002/clc.24136. Epub 2023 Aug 24.
Left ventricular and left atrial strain are sensitive and reliable markers for evaluating cardiac function in patients with type 2 diabetes mellitus (T2DM), with interactions between the two parameters. The present study aimed to analyze the correlation between global longitudinal strain (GLS) of the left ventricle and glycated hemoglobin (HbA1c) levels in patients with T2DM.
A total of 292 patients clinically diagnosed with T2DM were selected and divided into three groups according to HbA1c level. The strains of the left atrium and left ventricle in the three groups of T2DM patients with different HbA1c levels were compared. Univariate and multivariate (including left atrial functional indicators) linear regression analyses were performed to assess the relationship between strain indicators and HbA1c levels. Generalized additive models were used to examine the relationship between strain indicators and HbA1c levels.
There were significant differences among the three groups in terms of age, microalbuminuria, total cholesterol, fasting blood glucose, postprandial blood glucose, and HbA1c level, and left atrial conduit longitudinal strain (LAScd) and GLS (p < .05). Univariate and multivariate linear regression analyses revealed that, as HbA1c levels increased, the absolute value of GLS gradually decreased (p < .001). Curve fitting revealed a positive correlation between HbA1c level and GLS, which was not affected by left atrial function.
Left ventricular GLS was independently correlated with HbA1c level in patients with T2DM and was not affected by left atrial function.
左心室和左心房应变是评估 2 型糖尿病(T2DM)患者心功能的敏感和可靠标志物,两者之间存在相互作用。本研究旨在分析 T2DM 患者左心室整体纵向应变(GLS)与糖化血红蛋白(HbA1c)水平之间的相关性。
选择 292 例临床诊断为 T2DM 的患者,根据 HbA1c 水平分为三组。比较三组不同 HbA1c 水平的 T2DM 患者的左心房和左心室应变。进行单变量和多变量(包括左心房功能指标)线性回归分析,评估应变指标与 HbA1c 水平之间的关系。采用广义加性模型检验应变指标与 HbA1c 水平之间的关系。
三组患者在年龄、微量白蛋白尿、总胆固醇、空腹血糖、餐后血糖和 HbA1c 水平以及左心房管道纵向应变(LAScd)和 GLS 方面存在显著差异(p < .05)。单变量和多变量线性回归分析显示,随着 HbA1c 水平的升高,GLS 的绝对值逐渐降低(p < .001)。曲线拟合显示,HbA1c 水平与 GLS 之间存在正相关,且不受左心房功能的影响。
T2DM 患者左心室 GLS 与 HbA1c 水平独立相关,不受左心房功能的影响。