School of Medicine and Medical Sciences, Holy Spirit University Of Kaslik, Kaslik, Lebanon.
Faculty of Medicine and Medical Sciences, Department of Internal Medicine, Endocrinology Division, University of Balamand, Koura, Lebanon.
PLoS One. 2024 Sep 18;19(9):e0304801. doi: 10.1371/journal.pone.0304801. eCollection 2024.
Diabetes Mellitus is a prevalent disease with a growing impact on individuals worldwide. Evaluating the prevalence of subclinical left ventricular dysfunction and understanding its associations with microvascular complications, uncontrolled glycemia, diabetes duration, and patient age is crucial. Our aim is to determine the utility of screening for this condition.
We conducted a retrospective cohort study involving 159 asymptomatic individuals with type 2 diabetes. Bivariate analysis was employed to assess potential factors and their associations with subclinical left ventricular dysfunction. Patients with a history of cardiac disease or interventions were excluded.
The average age of our sample was 61.5 years. Almost half of the patients exhibited an HbA1c exceeding 7% (50.3%), and approximately half had an ejection fraction (EF) of less than 55% (50.9%). In the bivariate analysis, a notable difference in microvascular diabetic complications was observed among different EF groups. Specifically, nephropathy (62%), neuropathy (57.5%), and retinopathy (74.4%) were significantly more prevalent among patients with an EF < 55%. We also identified a significant age difference between groups, with a higher mean diabetes duration (14.1 ± 7.7 years) in the lower EF group. Notably, 63.7% of patients with an HbA1c exceeding 7% exhibited an EF < 55%. Older patients were associated with a lower EF, with an adjusted odds ratio (aOR) of 0.94. An HbA1c of 7% or less was linked to a higher likelihood of an EF > 55%.
We established a correlation between subclinical left ventricular systolic dysfunction and microvascular complications. However, further extensive prospective research is necessary to deepen our understanding of these associations and their clinical implications.
糖尿病是一种普遍存在的疾病，对全球个体的影响日益增加。评估亚临床左心室功能障碍的患病率，并了解其与微血管并发症、血糖控制不佳、糖尿病病程和患者年龄的关系至关重要。我们的目的是确定筛查这种情况的效用。
我们进行了一项回顾性队列研究，纳入了 159 名无症状的 2 型糖尿病患者。采用双变量分析评估潜在因素及其与亚临床左心室功能障碍的关系。排除有心脏疾病或干预史的患者。
我们样本的平均年龄为 61.5 岁。近一半的患者 HbA1c 超过 7%（50.3%），约一半的患者射血分数（EF）低于 55%（50.9%）。在双变量分析中，不同 EF 组之间微血管糖尿病并发症存在显著差异。具体而言，EF<55%的患者中，肾病（62%）、神经病（57.5%）和视网膜病变（74.4%）更为普遍。我们还发现不同 EF 组之间存在显著的年龄差异，EF 较低组的平均糖尿病病程较长（14.1±7.7 年）。值得注意的是，63.7%的 HbA1c 超过 7%的患者 EF<55%。年龄较大的患者 EF 较低，调整后的优势比（aOR）为 0.94。HbA1c 为 7%或以下与 EF>55%的可能性增加相关。
我们确立了亚临床左心室收缩功能障碍与微血管并发症之间的相关性。然而，需要进一步广泛的前瞻性研究来加深我们对这些关联及其临床意义的理解。
