Characterizing echocardiographic abnormalities and their associated factors in patients with type 1 diabetes: a cross-sectional study.

Abstract

Background: This study aims to characterize the prevalence of echocardiographic abnormalities and their associated factors in patients with type 1 diabetes.

Methods: Data from 362 patients with type 1 diabetes were analyzed. Echocardiographic abnormalities were defined based on echocardiography indicators and were classified as structural abnormalities or diastolic dysfunction subtype. Spearman's correlation, inter-group difference comparisons, modified Poisson regression and restricted cubic spline were conducted. Results were presented as prevalence ratio (PR) with 95% confidence interval (95% CI).

Results: The prevalence of echocardiographic abnormalities in this study was 32.60%, with cardiac structural abnormalities and ventricular diastolic dysfunction accounting for 19.61% and 21.27% respectively. As for demographic and lifestyle factors, older age (PR = 1.04, 95% CI 1.03 to 1.05), male sex (PR = 1.60, 95% CI 1.04 to 2.47), and smoking history (PR = 1.85, 95% CI 1.21 to 2.83) were associated with a higher prevalence of echocardiographic abnormalities while older onset age (PR = 0.93, 95% CI 0.88 to 0.98) was associated with a reduced prevalence. Concerning physical parameters, higher SBP (PR = 1.014, 95% CI 1.007 to 1.020), WHR in female (PR = 1.022, 95% CI 1.005 to 1.039), and WHtR in female (PR = 1.028, 95% CI 1.004 to 1.053) were associated with higher prevalence of echocardiographic abnormalities. Regarding islet function and autoantibodies, higher FCP (PR = 1.23, 95% CI 1.08 to 1.40) and 2 h-CP (PR = 1.08, 95% CI 1.02 to 1.14) were associated with an elevated prevalence of echocardiographic abnormalities while higher ICA titer (PR = 0.97, 95% CI 0.95 to 0.99) was associated with a lower prevalence. As for biochemical metabolic indicators, elevated level of FT4 (PR = 1.03, 95% CI 1.01 to 1.05), FT3 (PR = 1.11, 95% CI 1.02 to 1.21), and UACR (PR = 1.0002, 95% CI 1.00003 to 1.0004) were associated with a higher prevalence of echocardiographic abnormalities. As for comorbidities and complications, an increased prevalence of echocardiographic abnormalities was observed in patients with hypertension (PR = 1.37, 95% CI 1.04 to 1.80).

Conclusions: This study revealed a high prevalence of echocardiographic abnormalities in patients with type 1 diabetes, linked to aging, obesity, smoking, hypertension, islet function, thyroid function, renal function, and cardiovascular comorbidities. Further studies are needed to validate these findings.