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Exp Clin Endocrinol Diabetes 2015; 123(09): 515-523
DOI: 10.1055/s-0035-1550052
Article
© Georg Thieme Verlag KG Stuttgart · New York

Low-grade Albuminuria Associated with Subclinical Left Ventricular Diastolic Dysfunction and Left Ventricular Remodeling

S. Yan   *
1   Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
,
F. Yao   *
1   Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
,
L. Huang
1   Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
,
Q. Ruan
2   Ultrasonic Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
,
X. Shen
1   Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
,
S. Zhang
1   Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
,
C. Huang
2   Ultrasonic Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
› Author Affiliations
Further Information

Publication History

received 08 January 2015
first decision 03 April 2015

accepted 07 May 2015

Publication Date:
27 July 2015 (online)

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Abstract

Aims: Low-grade albuminuria (LGA) has been shown to be associated with increased risk for cardiovascular disease. Our study investigated the relationship between normal urinary albumin-to-creatinine ratios (UACRs) and subclinical left ventricular (LV) diastolic dysfunction and remodeling in diabetics and non-diabetics.

Methods: A total of 888 diabetic and 208 non-diabetic patients with normal UACRs (< 30 mg/g) from Fuzhou, Fujian Province, China were examined. The subjects were stratified into quartiles based on their respective UACR levels. LV diastolic function was defined by early diastolic transmitral velocities (E)/average early diastolic annular velocities (average e), accompanied by average e. LV remodeling was defined by LV mass indexed to body surface area and relative wall thickness based on 2-dimensional and Doppler echocardiography.

Results: UACR was independently associated with cardiac diastolic function as defined by E/e and average e (OR=1.042, P=0.001) and LV remodeling (OR=1.037, P=0.001) in all participants. Diabetic patients in the highest quartile of UACR demonstrated a greater risk of developing LV diastolic dysfunction by a magnitude of 1.625 (OR=1.625, P=0.037) than patients in the lowest quartile; those in the third and highest quartiles demonstrated a greater risk of LV remodeling by a magnitude of 1.729–1.994 compared to the lowest quartile (OR=1.729, P=0.027 and OR=1.994, P=0.005, respectively). The association between UACR and subclinical diastolic dysfunction was most prevalent in younger, non-obese, non-hypertensive females or patients who had experienced diabetes for fewer than 10 years. The association between UACR and LV remodeling was most prevalent in non-obese, older males, in patients with normal low-density lipoprotein levels, in patients who had experienced diabetes for fewer than 10 years, and in patients without hypertension.

Conclusion: UACR was associated with subclinical LV diastolic dysfunction and remodeling in both patients with and without Type 2 diabetes. We conclude that LGA may also be a marker for subclinical cardiovascular damage in Type 2 diabetics.

Key words

type 2 diabetes mellitus - low-grade albuminuria - echocardiography - left ventricular diastolic dysfunction - left ventricular remodeling

* The first two authors contributed equally to this work.


 

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