Evaluation of Left Ventricular Function in Type-2 Diabetes Mellitus with Microalbuminuria

Abstract

BACKGROUND This study intends to assess the left ventricular function in patients with type-2 diabetes mellitus with microalbuminuria and investigate whether any relationship exists between severity of microalbuminuria and duration of diabetes. METHODS Type-2 DM patients fulfilling the inclusion and exclusion criteria were subjected to test for Urine Albumin-to-Creatinine Ratio (UACR) using Combilyzer13 strips. Echocardiographic assessment was done using standard criteria in those patients who were positive for microalbuminuria. Statistical analysis was performed using chi-square test, t-test, and correlation test using SPSS software. RESULTS 102 patients out of 408 selected Type-2 DM patients were positive for microalbuminuria. UACR was positive in 25% of the studied population with male-29% and female-19%. Microalbuminuria was significantly associated with male sex (p<0.05). The age range in the study group was 42-68 years (mean 54.44 years), the duration of the disease was from 8-22 years (mean 14.70 years). BMI in the study group was from 18.54 to 38.62 (mean 27.78). The mean values of the lipid profile were Cholesterol-232.34 mg/dL, TG-188.53 mg/dL, HDL 29.39 mg/dL, VLDL 60.38 mg/dL, LDL 159.31 mg/dL which shows an atherogenic lipid profile in the study population. The mean values of FBS and PPBS were 135.90 mg/dL and 221.75 mg/dL respectively. HbA1c had ranges from 5.1 to 9.2 (mean 6.55). LV diastolic and systolic dysfunction was observed in 43.14% and 38.24% of patients respectively. Global LV dysfunction was noted in 8.82% of subjects. Systolic dysfunction showed significant correlation with severity of microalbuminuria and duration of disease with p values <0.01 each. Diastolic dysfunction also showed significant correlation with duration of diabetes (p<0.01) and severity of microalbuminuria. CONCLUSIONS Left ventricular dysfunction occurs in Type-2 DM with microalbuminuria. It correlates well with both severity of microalbuminuria and duration of diabetes.