Association of microalbuminuria with left ventricular dysfunction in Nigerian normotensive type 2 diabetes patients

Shogade, Taiwo Tolulope; Essien, I. O.; Ekrikpo, Udeme Ekpenyong; Umoh, Idongesit; Utin, Clement Tom; Unadike, B C; Andy, Joseph J.

doi:10.5830/cvja-2018-026

Cited by 6 publications

(6 citation statements)

References 19 publications

(22 reference statements)

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“…[19] Shogade et al , in their study of Nigerian normotensive type 2 diabetes subjects, noted that LV diastolic dysfunction (LVDD) showed a stepwise increase from the healthy controls to the normoalbuminuric to the microalbuminuric type 2DM subjects (16.9 vs 61.9 vs 78.9%, respectively) (p < 0.001), while E/A ratio and fractional shortening showed a significant stepwise decrease (both p < 0.001). [20] These findings are comparable with present study. Cyrille Bergerot et al found that albuminuria and retinopathy were associated with an increased risk of deterioration of diastolic function in type 2 DM subjects and concluded that presence of these co-factors might help to early identify subjects at risk of heart failure.…”

Section: Resultssupporting

confidence: 92%

“…This could be due to less number of subjects (n=32) in study by Braga et al [ Table 6] Mitral E velocity, E/A ratio was lower and mitral A velocity, Mitral deceleration time was higher in the groups with albuminuria than in the group without albuminuria. 20 Shogade et al (2018) 193 LVDD showed a stepwise increase from the healthy controls to the normoalbuminuric to the microalbuminuric T2DM subjects (16.9 vs 61.9 vs 78.9%, p < 0.001).…”

Section: Resultsmentioning

confidence: 93%

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Relation of Retinopathy and Microalbuminuria With Diastolic Dysfunction in Subjects With Type 2 Diabetes Mellitus

2020

jcr

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Background: Prevalence of heart failure in asymptomatic type 2 DM subjects is increasing. Presence of microvascular complications like retinopathy and microalbuminuria, is under evaluation for predicting cardiovascular complications like heart failure in type 2 DM subjects. Aims and objectives: To study the relation between diabetic retinopathy and microalbuminuria with presence and grades of diastolic dysfunction in type 2 diabetes mellitus (DM) subjects. Materials and methods: This was a cross-sectional, observational study. A total of 62 subjects with type 2 diabetes mellitus (Type-2 DM) were enrolled. Fundoscopy examination for diabetic retinopathy, urine for microalbuminuria and standardized transthoracic echocardiographic (TTE) examination were performed. Left ventricular diastolic dysfunction (LVDD) was labeled if ≥3 of variables were present: "Septal e <7 cm/sec or Lateral e <10 cm/sec, E/e ratio >14, LA volume index >34 mL/m 2 , Peak TR velocity >2.8 m/sec. Results: The peak early trans-mitral filling wave velocity (E) was low in subjects with diabetic retinopathy [40 ± 11.6 cm/s vs 46 ± 9.6cm/s]. Mean of E/A ratio in subjects with diabetic retinopathy group was significantly lower compared to those without retinopathy ('p' < 0.03). The E/e' ratio was significantly higher in subjects with retinopathy (15.7 ± 2.48 vs 13.24 ± 1.88, p<0.02). The subjects with retinopathy and/or microalbuminuria had lower mean E/A ratio, deceleration time (DT), e' and higher E/e' ratio. Total 14(22.58%) subjects had diabetic retinopathy, all had mild non-proliferative diabetic retinopathy (NPDR) and 20(32.26%) subjects had microalbuminuria. Total 28 (45.16%) subjects had diastolic dysfunction [grade I: 24 (85.71%), grade-II: 4 (14.29%)]. Amongst 28 subjects with LVDD, 10(35.71%) had diabetic retinopathy and 15(53.57%) had microalbuminuria. Significant association was present between presence of retinopathy and microalbuminuria with diastolic dysfunction (p=0.024 and 0.001, respectively). Conclusion: Prevalence of LVDD in asymptomatic type 2 diabetes mellitus subject was 45.16%. Present study highlighted strong association between presence of diabetic retinopathy and microalbuminuria with LV diastolic dysfunction in subjects with type 2 diabetes mellitus.

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Section: Resultssupporting

confidence: 92%

Section: Resultsmentioning

confidence: 93%

Relation of Retinopathy and Microalbuminuria With Diastolic Dysfunction in Subjects With Type 2 Diabetes Mellitus

2020

jcr

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“…There was significant difference in mean duration of diabetes between microalbuminuric and normoalbuminuric groups in our study, which is comparable to the studies of Kanwar BS et al and Shogade TT et al [11,12].…”

Section: Discussionsupporting

confidence: 91%

“…Our patients in the study were predominantly from the age group of 51-60 years and the difference in gender distribution of patients between the two groups was insignificant. This patient profile in our study is similar to [11][12][13][14].…”

Section: Discussionsupporting

confidence: 82%

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Association of microalbuminuria with left ventricular dysfunction in type 2 diabetes mellitus

Mehta¹,

Godbole²,

Mehta³

et al. 2021

Egypt J Intern Med

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Background The prevalence of diabetes mellitus is on rising trend in developing countries like India. In type 2 diabetes patients, albuminuria has been shown to predict development of dysfunction in other organ systems such as kidneys, nervous system, and retina and increase risk of cardiovascular (CV) morbidity and mortality. In this study, we plan to assess association of microalbuminuria with left ventricular dysfunction in type 2 diabetes mellitus. Results This cross-sectional study was conducted among 100 type 2 diabetes mellitus patients attending a tertiary care hospital in Gujarat, Western India. Based on urine albumin excretion status, they were divided in two groups of 50 each—normoalbuminuric and microalbuminuric patients. The mean FBS, PPBS, and HbA1c level was significantly lower in normoalbuminuric group compared to microalbuminuric group. There was an increase in cholesterol, triglyceride, VLDL, and LDL levels and decrease in HDL levels in microalbuminuric group as compared to normoalbuminuric group. Multivariate logistic regression analysis revealed that increase in age and a decrease in E/A ratio in patients with microalbuminuria was significantly associated with left ventricular diastolic dysfunction (LVDD). Conclusion The presence of microalbuminuria is associated with increased likelihood of LVDD in type 2 diabetes patients. Increase in age and decrease in E/A ratio show direct and independent association with LVDD in normotensive diabetic patients with microalbuminuria. Therefore, diabetes patients who have microalbuminuria should be regularly (or more frequently) evaluated for development of LVDD using Echocardiography. This can allow early identification of myocardial diastolic dysfunction.

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Epidemiology of heart failure in diabetes: a disease in disguise

Hoek,

Dal Canto,

Wenker

et al. 2024

Diabetologia

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Left ventricular diastolic dysfunction (LVDD) without symptoms, and heart failure (HF) with preserved ejection fraction (HFpEF) represent the most common phenotypes of HF in individuals with type 2 diabetes mellitus, and are more common than HF with reduced ejection fraction (HFrEF), HF with mildly reduced ejection fraction (HFmrEF) and left ventricular systolic dysfunction (LVSD) in these individuals. However, diagnostic criteria for HF have changed over the years, resulting in heterogeneity in the prevalence/incidence rates reported in different studies. We aimed to give an overview of the diagnosis and epidemiology of HF in type 2 diabetes, using both a narrative and systematic review approach; we focus narratively on diagnosing (using the 2021 European Society of Cardiology [ESC] guidelines) and screening for HF in type 2 diabetes. We performed an updated (2016–October 2022) systematic review and meta-analysis of studies reporting the prevalence and incidence of HF subtypes in adults ≥18 years with type 2 diabetes, using echocardiographic data. Embase and MEDLINE databases were searched and data were assessed using random-effects meta-analyses, with findings presented as forest plots. From the 5015 studies found, 209 were screened using the full-text article. In total, 57 studies were included, together with 29 studies that were identified in a prior meta-analysis; these studies reported on the prevalence of LVSD (n=25 studies, 24,460 individuals), LVDD (n=65 studies, 25,729 individuals), HFrEF (n=4 studies, 4090 individuals), HFmrEF (n=2 studies, 2442 individuals) and/or HFpEF (n=8 studies, 5292 individuals), and on HF incidence (n=7 studies, 17,935 individuals). Using Hoy et al’s risk-of-bias tool, we found that the studies included generally had a high risk of bias. They showed a prevalence of 43% (95% CI 37%, 50%) for LVDD, 17% (95% CI 7%, 35%) for HFpEF, 6% (95% CI 3%, 10%) for LVSD, 7% (95% CI 3%, 15%) for HFrEF, and 12% (95% CI 7%, 22%) for HFmrEF. For LVDD, grade I was found to be most prevalent. Additionally, we reported a higher incidence rate of HFpEF (7% [95% CI 4%, 11%]) than HFrEF 4% [95% CI 3%, 7%]). The evidence is limited by the heterogeneity of the diagnostic criteria over the years. The systematic section of this review provides new insights on the prevalence/incidence of HF in type 2 diabetes, unveiling a large pre-clinical target group with LVDD/HFpEF in which disease progression could be halted by early recognition and treatment.Registration PROSPERO ID CRD42022368035. Graphical Abstract

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Association of microalbuminuria with left ventricular dysfunction in Nigerian normotensive type 2 diabetes patients

Cited by 6 publications

References 19 publications

Relation of Retinopathy and Microalbuminuria With Diastolic Dysfunction in Subjects With Type 2 Diabetes Mellitus

Relation of Retinopathy and Microalbuminuria With Diastolic Dysfunction in Subjects With Type 2 Diabetes Mellitus

Association of microalbuminuria with left ventricular dysfunction in type 2 diabetes mellitus

Epidemiology of heart failure in diabetes: a disease in disguise

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