Correlation between HbA1c levels and left ventricular function in children with Type 1 Diabetes Mellitus

Abstract

Background: Diabetic cardiomyopathy is one of the macrovascular complications in type 1 diabetes mellitus (T1DM). Left ventricular dysfunction primarily reflects diastolic dysfunction which is early sign of diabetic cardiomyopathy. Improved glycemic control can delay the onset and progression of this complication. An important indicator of long-term glycemic control is glycosylated hemoglobin (HbA1c). Objective: The aim of this study is to evaluate the correlation between HbA1c levels with left ventricular diastolic function in children with T1DM. Methods: This study was an observational study with cross-sectional design in children aged 1 month-18 years with T1DM, at Prof Dr. I.G.N.G. Ngoerah Hospital, Denpasar from November 2019–September 2021, using consecutive sampling. Glycosylated hemoglobin (HbA1c) was meassured by blood samping and LV function was assessed by using tissue Doppler imaging (TDI). Statistical analysis was done by Pearson and Spearman correlation test. A p-values of <0.05 was considered statistically significant. Results: A total of 36 subjects were recruited in this study. There was a low positive correlation between HbA1c levels with E/e’ ratio (r=0.284, p=0.047), and MPI (r=0.358, p=0.020). After adjusting body mass index and duration of T1DM as confounding variables, we found a low positive correlation between HbA1c levels and E/e’ ratio (r=0.325, p=0.030), MPI (r = 0.390, p=0.020). Conclusion: HbA1C has a positive correlation with left ventricular diastolic function in children with T1DM.