Lipid Biomarkers as Predictors of Diastolic Dysfunction in Diabetes with Poor Glycemic Control

Abstract

Uncontrolled type-1 diabetes (T1DM) can lead to dyslipidaemia and albuminuria, which may promote cardiovascular injuries. However, some lipidemic factors could be useful in predicting cardiac dysfunction. Seventy-eight adolescents under insulin treatment due to a 6-year history of T1DM and were retrospectively examined. Glycemia, lipidemia, and albuminuria were measured in addition to development of cardiovascular abnormalities Both girls and boys showed higher HbA1c and fasting blood glucose and 27.1% females and 33.3% males exhibited microalbuminuria though their plasma levels of total cholesterol (TC), triglycerides (TG), and low-density lipoproteins (LDL) and high-density lipoproteins (HDL lipoproteins were in the normal range. They exhibited a preserved systolic function, but 50% of females and 66.6% of males had developed diastolic failures. Interestingly, girls with diastolic dysfunction showed significantly lower concentrations of HDL and higher TC/HDL and TG/HDL ratios. In fact, low HDL levels (OR 0.93; 95% CI 0.88–0.99; p = 0.029) and high TC/HDL (OR 2.55; 95% CI 1.9–5.45; p = 0.016) and TG/HDL (OR 2.74; 95% CI 1.12–6.71; p = 0.028) ratios associated with the development of diastolic complications. The cut-off values for HDL, TC/HDL, and TG/HDL were 49 mg/dL, 3.0 and 1.85, respectively. HDL and TC/HDL and TG/HDL ratios may be useful for predicting diastolic dysfunction in girls with uncontrolled T1DM.

Heart Failure in Type 1 Diabetes: A Complication of Concern? A Narrative Review

“…Finally, regarding risk factors, there is an interesting study carried out by Khedr et al on 78 adolescents with T1D of at least 6 years of duration, in whom they analyzed some lipid biomarkers as predictors of diastolic dysfunction. They found diastolic failure to occur in 50% of the females and 66.6% of the males, and described that lower high-density lipoproteins (HDL) (OR 0.93, 95% CI 0.88–0.99) and a higher total cholesterol/HDL ratio (OR 2.55, 95% CI 1.9–5.45) and triglycerides/HDL ratio (OR 2.74, 95% CI 1.12–6.71) were associated with diastolic failure [ 22 ].…”

Dissecting the Association of Apolipoprotein E Gene Polymorphisms With Type 2 Diabetes Mellitus and Coronary Artery Disease

“…Therefore, abnormalities of lipoprotein metabolism may partly explain that the plasma HDL-C levels were lowest in APOE4 patients compared to APOE3 and APOE2 patients in CAD group. Besides, excessive amounts of circulant lipids may affect systemic inflammation and insulin resistance (IR) ( 21 , 22 ). Previous studies reported the TG/HDL-C ratio as predictor of IR ( 22 ).…”

“…Besides, excessive amounts of circulant lipids may affect systemic inflammation and insulin resistance (IR) ( 21 , 22 ). Previous studies reported the TG/HDL-C ratio as predictor of IR ( 22 ). A higher ratio indicated a large amount of circulant lipids.…”

Weighted Gene Co-Expression Network Analysis Identifies ANGPTL4 as a Key Regulator in Diabetic Cardiomyopathy via FAK/SIRT3/ROS Pathway in Cardiomyocyte

“…Dyslipemia can enforce tissue damage and reduce its glucose assimilation. In consequence, increased oxidation, inflammation, and atherogenesis could lead to cardiovascular abnormalities and heart dysfunction ( 40 ). Oxidative stress has also been implicated in the onset and progression of cardiovascular diseases such as congestive heart failure and diabetes-associated heart dysfunction ( 42 ).…”

“…The human genetics studies showed that genetic inactivation of ANGPTL4 improves glucose and lipid homeostasis and is associated with reduced risk of coronary artery disease and diabetes (37)(38)(39). Hyperglycemia is an important risk factor for DbCM in type 1 diabetic adolescent, leading to diastolic and systolic dysfunction (40,41). The excess of glucose may deviate to deleterious metabolites and activation of pro-oxidative and inflammatory pathways, damaging pancreas and other peripheral tissue such as heart.…”