Association of Serum Uric Acid with Biventricular Myocardial Dysfunction in Patients with type 2 Diabetes Mellitus: A Cross-sectional Study

Abstract

BackgroundIncreased serum uric acid (SUA) is common in patients with type 2 diabetes mellitus (T2DM) and is associated with left ventricular (LV) myocardial dysfunction. Nonetheless the association of SUA with right ventricular (RV) function in patients with T2DM has not been studied. This study aimed to investigate the association of SUA with biventricular myocardial function in patients with T2DM.MethodsA total of 560 patients with T2DM were enrolled and divided into four groups according to quartile of SUA. Transthoracic echocardiography was performed and two-dimensional speckle tracking used to measure biventricular myocardial strain, including LV global longitudinal strain (GLS), circumferential strain (CS), radial strain (RS), and RV free wall longitudinal stra in (RV-FWLS).Results The absolute value of all biventricular strain parameters showed a stepwise decrease across SUA quartiles (all P<0.01). In particular, LV assessment by GLS, CS and RS demonstrated that those in the 4th quartile were impaired compared with the other quartiles (all P<0.05). Similarly, RV-FWLS of the 4th quartile was significantly impaired compared with the 1st and 2nd quartiles (all P<0.05). The same reduction in biventricular strain across SUA quartiles was observed in patients with estimated glomerular filtration rate＜or ≥60 ml/min/1.73 m2, and glycated hemoglobin < or ≥7.0% (all P<0.05). Multivariable linear regression analysis demonstrated that higher quartile of SUA was independently associated with impaired biventricular myocardial strain (all P<0.05). ConclusionsSUA was independently associated with biventricular myocardial dysfunction in asymptomatic T2DM patients, regardless of renal function or diabetic control.