Youth with type 1 diabetes have worse strain and less pronounced sex differences in early echocardiographic markers of diabetic cardiomyopathy compared to their normoglycemic peers: A RESistance to InSulin in Type 1 ANd Type 2 diabetes (RESISTANT) Study.
Youth with type 1 diabetes have worse strain and less pronounced sex differences in early echocardiographic markers of diabetic cardiomyopathy compared to their normoglycemic peers: A RESistance to InSulin in Type 1 ANd Type 2 diabetes (RESISTANT) Study.
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DOI：
10.1016/j.jdiacomp.2016.04.008
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发表时间：
2016-08
影响因子：
3
通讯作者：
Nadeau KJ
中科院分区：
文献类型：
--
作者：
Bjornstad P;Truong U;Pyle L;Dorosz JL;Cree-Green M;Baumgartner A;Coe G;Regensteiner JG;Reusch JE;Nadeau KJ
糖尿病性心肌病是发病的主要原因，但关于1型糖尿病（T1 D）早期心脏异常的数据有限。我们研究了有和没有T1 D的青少年心肌应变的差异。我们假设患有T1 D的青少年比血糖正常的同龄人有更严重的压力，男孩比女孩有更严重的压力，并且这种压力与血糖控制和脂肪因子相关。我们进行了空腹实验室测量和超声心动图斑点追踪，以评价传统超声心动图测量以及纵向（LS）和周向（CS）应变，并在青少年（15±2岁）中（19名男孩; 22名女孩）和无1型糖尿病（16名男孩; 32名女孩）。与对照组相比，青少年1型糖尿病患者的CS显著降低（-20.9 vs.-22.7%，p=0.02），但LS没有降低（p=0.83）。根据坦纳分期调整后，T1 D男孩的LS显著低于T1 D女孩（−17.5 vs. − 19.7%，p=0.047）。在对照组中观察到的左室质量指数、左室舒张末期容积、舒张期间隔和后壁厚度的显著性别差异在T1 D青少年中缺乏。我们的观察结果表明，青年T1 D有更糟糕的心肌应变比血糖正常的同龄人。此外，与对照组中的男孩相比，在女孩中观察到的相对有利的心脏特征在T1 D中减弱。T1 D青年患者的这些早期心血管变化令人担忧，值得进行纵向和机制研究。
Diabetic cardiomyopathy is a major cause of morbidity, but limited data are available on early cardiac abnormalities in type 1 diabetes (T1D). We investigated differences in myocardial strain in adolescents with and without T1D. We hypothesized that adolescents with T1D would have worse strain than their normoglycemic peers, which boys would have worse strain than girls, and that strain would correlate with glycemic control and adipokines. We performed fasting laboratory measures and echocardiograms with speckle tracking to evaluate traditional echocardiographic measures in addition to longitudinal (LS) and circumferential (CS) strain, and in adolescents (15±2 years) with (19 boys; 22 girls) and without (16 boys; 32 girls) type 1 diabetes. Compared to controls, adolescents with type 1 diabetes had significantly lower CS (−20.9 vs. −22.7%, p=0.02), but not LS (p=0.83). Boys with T1D had significantly lower LS than girls with T1D (−17.5 vs. −19.7%, p=0.047), adjusted for Tanner stage. The significant sex differences observed in indexed left ventricular mass, left end-diastolic volume, diastolic septal and posterior wall thickness in our controls were lacking in adolescents with T1D. Our observations suggest that youth with T1D have worse myocardial strain than normoglycemic peers. In addition, the relatively favorable cardiac profile observed in girls vs. boys in the control group, was attenuated in T1D. These early cardiovascular changes in youth with T1D are concerning and warrant longitudinal and mechanistic studies.