Oksen Dogac, Aslan Muzaffer, Yavuz Yunus Emre, Kaynak Cagdas, Tekin Esra Erturk
Department of Cardiology, Altinbas University, Istanbul, Turkey.
Department of Cardiology, Siirt University, Siirt, Turkey.
Diab Vasc Dis Res. 2025 May-Jun;22(3):14791641251346268. doi: 10.1177/14791641251346268. Epub 2025 May 24.
Introduction & ObjectiveLatent autoimmune diabetes mellitus (LADA), a heterogeneous disease, is much more common in society than thought. Although it has been claimed that LADA is similar to type 2 diabetes mellitus (T2DM) from a cardiovascular perspective, there is no clear consensus. In this context, the objective of this study is to assess subclinical dysfunction in the left and right ventricles in patients with LADA using novel tissue Doppler imaging (TDI) parameters.Materials &MethodsThe sample of this observational case-control study consisted of 57 consecutive patients aged between 30 and 70 years who applied to the endocrinology and metabolism outpatient clinics, were diagnosed with LADA, and were referred to the cardiology clinic for echocardiographic (ECHO) evaluation. The control group consisted of 60 healthy volunteers. Participants' demographic and clinical characteristics and laboratory findings were recorded. All participants underwent ECHO using conventional ECHO and TDI. Subclinical left ventricular dysfunction was assessed using the myocardial performance index (MPI) and isovolumic myocardial acceleration (IVA).ResultsThere were no significant differences between the patient and control groups in terms of conventional ECHO parameters. The left ventricular (LV) MPI was significantly higher in the patient group than in the control group (0.54 ± 0.11 vs 0.47 ± 0.07, 0.008). There was no significant difference between the groups in right ventricular (RV) MPI (0.49 ± 0.10 vs 0.46 ± 0.70, 0.217). IVA was decreased in both ventricles (IVA mitral: 3.03 ± 1.44 vs 3.78 ± 1.66, 0.008 and IVA tricuspid: 2.67 ± 0.88 vs 3.42 ± 0.97, 0.034). Both LV IVA and RV IVA were found to be significantly correlated with glutamic acid decarboxylase antibodies' (GADA) levels in the negative direction (R = -0.290, 0.005 and R = -0.340, 0.001).ConclusionsIt was observed that LADA negatively affected the systolic and diastolic functions of both ventricles, with its effect being more pronounced in the left ventricle. Glycemic control and autoantibody titers were found to be correlated with TDI parameters, emphasizing their relevance in assessing cardiac dysfunction.
引言与目的
潜伏性自身免疫性糖尿病（LADA）是一种异质性疾病，在社会中比人们想象的更为常见。尽管有人声称从心血管角度来看LADA与2型糖尿病（T2DM）相似，但尚无明确共识。在此背景下，本研究的目的是使用新型组织多普勒成像（TDI）参数评估LADA患者左右心室的亚临床功能障碍。
材料与方法
本观察性病例对照研究的样本包括57例年龄在30至70岁之间的连续患者，他们前往内分泌与代谢门诊就诊，被诊断为LADA，并被转介至心脏病门诊进行超声心动图（ECHO）评估。对照组由60名健康志愿者组成。记录参与者的人口统计学和临床特征以及实验室检查结果。所有参与者均接受常规ECHO和TDI检查。使用心肌性能指数（MPI）和等容心肌加速度（IVA）评估亚临床左心室功能障碍。
结果
在常规ECHO参数方面，患者组和对照组之间无显著差异。患者组的左心室（LV）MPI显著高于对照组（0.54±0.11对0.47±0.07，P = 0.008）。右心室（RV）MPI在两组之间无显著差异（0.49±0.1对0.46±0.7，P = 0.217）。两个心室的IVA均降低（二尖瓣IVA：3.03±1.44对3.78±1.66，P = 0.008；三尖瓣IVA：2.67±0.88对3.42±0.97，P = 0.034）。发现LV IVA和RV IVA均与谷氨酸脱羧酶抗体（GADA）水平呈显著负相关（R = -0.290，P = 0.005；R = -0.340，P = 0.001）。
结论
观察到LADA对两个心室的收缩和舒张功能均产生负面影响，对左心室的影响更为明显。血糖控制和自身抗体滴度与TDI参数相关，强调了它们在评估心脏功能障碍中的相关性。
