Diabetic Microvascular Disease Associated with Left Ventricular Hypertrophy in T2D

Source: unsplash

Diabetic microvascular diseases, including diabetic retinopathy and diabetic kidney disease, were positively associated with left ventricular hypertrophy in patients with type 2 diabetes (T2D), according to new research.¹

The findings, presented at the 83rd Scientific Sessions of the American Diabetes Association (ADA 2023), suggested the risk of left ventricular hypertrophy increased with the number of microvascular diseases, particularly in male patients.

“Diabetic microvascular diseases, especially diabetic retinopathy and diabetic kidney disease (DKD) were positively and independently associated with left ventricular hypertrophy in T2D,” wrote the investigative team, led by Jing Ke, from the Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University.

An important feature in patients with diabetes, left ventricular hypertrophy has been shown to increase the risk of cardiac events, including heart failure and cardiovascular death.² However, the pathophysiology of left ventricular hypertrophy in T2D is still known and cannot be fully explained by hyperglycemia and hypertension. Ke and colleagues suggest microvascular diseases, the most common and specific complication of diabetes, could be involved in left ventricular hypertrophy.

The team explored the association between diabetic microvascular diseases and left ventricular hypertrophy in patients with T2D. The cross-sectional analysis enrolled 2912 patients with T2D, including a total of 360 patients with left ventricular hypertrophy and 2552 patients without left ventricular hypertrophy. Investigators collected data on demographics, medical history, anthropometric indices, laboratory examination, diabetic microvascular diseases, and cardiac ultrasound index.

Investigators additionally performed laboratory examinations, diabetic microvascular disease detection, and cardiac ultrasonography. Correlation analysis and regression analysis were used to analyze the relationship between diabetic microvascular diseases and left ventricular hypertrophy in the study population and gender subgroup.

In the population with T2D, those with left ventricular hypertrophy were older and had larger body mass index (BMI), waist circumference, and hip circumference, as well as subcutaneous fat area, than patients without left ventricular hypertrophy.

Upon analysis, investigators found those with left ventricular hypertrophy had a larger proportion of hypertension, coronary heart disease, diabetic retinopathy, and diabetic kidney disease. After adjustments for potential confounding factors, patients with diabetic retinopathy and diabetic kidney disease had a greater likelihood of left ventricular hypertension (odds ratio [OR], 1.351 and OR, 1.404, respectively. Investigators noted the risk of left ventricular hypertrophy gradually increased in patients with 2 or 3 diabetic microvascular diseases than in those patients with only a single disease.

Additionally, the team noted a higher proportion of males had left ventricular hypertrophy compared with female patients (69.7% and 30.3%, respectively). In the gender subgroup analysis, investigators noted the risk of left ventricular hypertrophy gradually increased with the number of diabetic microvascular diseases in male patients.

“In addition, the risk of left ventricular hypertrophy obviously increased with the number of microvascular diseases in males with T2D,” the investigative team wrote.

References

1. Ke J, Feng X, Xu Y, Zhu L, Yang L, Zhao D. Diabetic microvascular disease is associated with left ventricular hypertrophy in patients with type 2 diabetes mellitus. Poster presentation at the 83rd Scientific Sessions of the American Diabetes Association. June 23 – 26, 2023
2. Left ventricular hypertrophy - statpearls - NCBI bookshelf. National Library of Medicine. April 30, 2023. Accessed June 30, 2023. https://www.ncbi.nlm.nih.gov/books/NBK557534/.