Influencing factors on cardiac structure and function beyond glycemic control in patients with type 2 diabetes mellitus.
Influencing factors on cardiac structure and function beyond glycemic control in patients with type 2 diabetes mellitus.
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DOI：
10.1186/1475-2840-12-38
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发表时间：
2013-02-27
影响因子：
9.3
通讯作者：
Daida H
中科院分区：
文献类型：
--
作者：
Ichikawa R;Daimon M;Miyazaki T;Kawata T;Miyazaki S;Maruyama M;Chiang SJ;Suzuki H;Ito C;Sato F;Watada H;Daida H
我们假设血糖控制以外的临床因素可能影响2型糖尿病（T2 DM）患者的心功能异常。本研究旨在探讨2型糖尿病临床因素中心功能异常的独立因素。我们研究了148例无明显心脏病的无症状T2 DM患者。超声心动图的结果进行了比较糖尿病患者和68名年龄匹配的健康受试者。测量舒张早期（E）和舒张晚期（A）二尖瓣血流速度和舒张早期二尖瓣环速度（e '）以评估左心室（LV）舒张功能。我们评估了胰岛素抵抗、非酯化脂肪酸、高敏CRP、估计的肾小球滤过率、腰/臀比、腹部内脏脂肪组织（VAT）、皮下脂肪组织（SAT）和除血糖控制外的其他临床特征。通过计算机断层扫描对VAT和SAT进行定量。与对照组相比，T2 DM患者的E/A和e'显著降低，E/e'、左房容积和LV质量显著增加。在多变量线性回归分析中，VAT是左心房容积（β =0.203，p=0.011）、E/A（β =−0.208，p=0.002）、e'（β =−0.354，p<0.001）和E/e'（β=0.220，p=0.003）的独立决定因素。年龄也是一个独立的决定因素，而空腹血糖和血红蛋白A1 c水平不是。除收缩压外，腰臀比（β=0.173，p=0.024）和VAT/SAT比值（β=0.162，p=0.049）是LV质量的独立决定因素。内脏脂肪过多伴脂肪细胞功能障碍可能比血糖控制在T2 DM舒张功能障碍和LV肥大的发生中发挥更大的作用。
We hypothesized that clinical factors other than glycemic control may influence abnormal cardiac function in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the independent factors for abnormal cardiac function among clinical factors in T2DM. We studied 148 asymptomatic patients with T2DM without overt heart disease. Echocardiographic findings were compared between diabetic patients and 68 age-matched healthy subjects. Early (E) and late (A) diastolic mitral flow velocity and early diastolic mitral annular velocity (e’) were measured for assessing left ventricular (LV) diastolic function. We evaluated insulin resistance, non-esterified fatty acid, high-sensitive CRP, estimated glomerular filtration rate, waist/hip ratio, abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and other clinical characteristics in addition to glycemic control. VAT and SAT were quantified by computed tomography. In T2DM, E/A and e’ were significantly lower, and E/e’, left atrial volume and LV mass were significantly greater than in control subjects. In multivariate liner regression analysis, VAT was an independent determinant of left atrial volume (β =0.203, p=0.011), E/A (β =−0.208, p=0.002), e’ (β =−0.354, p<0.001) and E/e’ (β=0.220, p=0.003). Age was also an independent determinant, whereas fasting plasma glucose and hemoglobin A1c levels were not. In addition to systolic blood pressure, waist-hip ratio (β=0.173, p=0.024) and VAT/SAT ratio (β=0.162, p=0.049) were independent determinants of LV mass. Excessive visceral fat accompanied by adipocyte dysfunction may play a greater role than glycemic control in the development of diastolic dysfunction and LV hypertrophy in T2DM.
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影响因子：
2.8
作者：
From, Aaron M.;Scott, Christopher G.;Chen, Horng H.
通讯作者：
Chen, Horng H.
DOI：
10.1111/j.1751-7133.2011.00276.x
发表时间：
2012-07-01
期刊：
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影响因子：
--
作者：
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通讯作者：
Dudley, Samuel C Jr
影响因子：
37.8
作者：
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通讯作者：
Sudhir, K
影响因子：
13.2
作者：
Matsuo, Seiichi;Imai, Enyu;Hishida, Akira
通讯作者：
Hishida, Akira
影响因子：
6
作者：
Gaikwad, Anil Bhanudas;Sayyed, Sufyan G.;Anders, Hans-Joachim
通讯作者：
Anders, Hans-Joachim