Albuminuria is independently associated with preclinical left ventricular systolic dysfunction: The TESEO study.

IF 4.6 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2025-09-15 DOI:10.4239/wjd.v16.i9.106914

Federica Barutta, Alessandro Andreis, Matteo Bellettini, Guglielmo Beccuti, Arianna Ferro, Martina Bollati, Stefania Bellini, Giulia Gioiello, Giulio Mengozzi, Gaetano M De Ferrari, Gianluca Alunni, Fabio Broglio, Gabriella Gruden

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Abstract

Background: Global longitudinal strain (GLS) of the left ventricular is a highly sensitive and reliable marker of systolic function and GLS outperforms ejection fraction (EF) in detecting preclinical left ventricular systolic dysfunction (LVSD). In patients with type 2 diabetes (DM2) albuminuria is a predictor of symptomatic heart failure, but data on the relationship between GLS and albuminuria are conflicting.

Aim: To explore the relationship between GLS and albuminuria in a contemporary cohort of DM2 patients.

Methods: The study was performed on DM2 patients consecutively enrolled in the TESEO study. Patients with symptoms/signs of heart failure, EF < 50%, coronary artery, other cardiac diseases, or non-adequate acoustic window for GLS assessment were excluded. We collected clinical data, screened for complications, and measured GLS by speckle-tracking echocardiography. Univariate and multiple linear regression analyses were performed to identify independent explanatory variables associated with GLS. Logistic regression analysis was used to assess whether albuminuria was independently associated with GLS-diagnosed (GLS > -18%) LVSD.

Results: Patients (n = 193, age: 60.6 ± 8.1, male: 57%) had a short DM2 duration (3.8 ± 4.9 years) and good metabolic control (glycated haemoglobin A1c: 6.5% ± 1.0). Preclinical GLS-LVSD was present in 21.8% of the patients. GLS values were significantly higher in patients with albuminuria (-19.88 ± 2.16 vs -18.29 ± 2.99, P < 0.001) and in multivariate analysis natural logarithm of albumin-creatinine ratio and uric acid were independent predictors of GLS. In logistic regression analysis, albuminuria was associated with a 6.01 (95% confidence interval: 1.874-19.286) increased odds ratio of GLS-LVSD, independent of age, sex, diastolic blood pressure, chronic kidney disease, EF, mitral annulus velocity lateral, uric acid, and treatments.

Conclusion: Albuminuria was independently associated with subclinical LVSD in our contemporary cohort of DM2 patients.

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蛋白尿与临床前左心室收缩功能障碍独立相关：TESEO研究。

背景：左心室整体纵向应变（GLS）是一个高度敏感和可靠的收缩功能指标，GLS在检测临床前左心室收缩功能障碍（LVSD）方面优于射血分数（EF）。在2型糖尿病（DM2）患者中，蛋白尿是症状性心力衰竭的一个预测指标，但是关于GLS和蛋白尿之间关系的数据是相互矛盾的。目的：探讨当代DM2患者GLS与蛋白尿的关系。方法：在连续入选TESEO研究的DM2患者中进行研究。排除有心衰症状/体征、EF < 50%、冠状动脉、其他心脏疾病或GLS评估声窗不足的患者。我们收集临床资料，筛选并发症，并通过斑点跟踪超声心动图测量GLS。进行单变量和多元线性回归分析，以确定与GLS相关的独立解释变量。采用Logistic回归分析来评估蛋白尿是否与GLS诊断的LVSD （GLS > -18%）独立相关。结果：患者193例，年龄：60.6±8.1岁，男性：57%)，DM2持续时间短（3.8±4.9年），代谢控制良好（糖化血红蛋白A1c: 6.5%±1.0）。21.8%的患者出现临床前GLS-LVSD。蛋白尿患者的GLS值明显较高（-19.88±2.16 vs -18.29±2.99,P < 0.001），在多变量分析中，白蛋白-肌酐比的自然对数和尿酸是GLS的独立预测因子。在logistic回归分析中，蛋白尿与GLS-LVSD的比值比增加6.01（95%可信区间：1.874-19.286）相关，与年龄、性别、舒张压、慢性肾病、EF、二尖瓣环速度外侧、尿酸和治疗无关。结论：在我们的当代DM2患者队列中，蛋白尿与亚临床LVSD独立相关。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.