Novel biomarkers for subtle myocardial involvement in type I diabetes mellitus

Abstract

Background Evaluation of certain biomarkers could be used to predict left ventricular (LV) and right ventricular (RV) function impairment in children with type 1 diabetes mellitus. The aim of this study was to determine the best cardiac biomarker for prediction of diabetic cardiomyopathy. Methodology This study was designed as case-control study. A total of 55 children with type 1 diabetes mellitus (group/G1) and 55 healthy controls (G2) were subjected to echocardiography including 3D-Speckle Tracking Echocardiography and tissue Doppler imaging for assessment of RV and LV systolic and diastolic functions. As well as HbA1c, troponin I, brain natriuretic peptide (BNP), plasma cardiotrophin (CT-1), activin-A, transforming growth factor-β, and human insulin-like growth factor binding protein-7 (IGFBP-7) measurements. Results Diabetic patients showed RV and LV systo-diastolic dysfunction compared to controls, the best predictor of LV systolic dysfunction was CT-1 (sensitivity: 69%, while IGFBP-7 was found to be the best predictor of RV systolic dysfunction (sensitivity: 63%). BNP was found to the best predictor of diastolic RV and LV dysfunction (sensitivity: 82% for both). Conclusion CT-1 has proven to be a diagnostic superiority in LV systolic dysfunction whilst BNP continues to prove every day through our study and through many others that it is the chief marker of diastolic dysfunction and HFpEF. This potential accuracy and the increasing availability of BNP in the outpatient setting make it clear that it should be used as a screening test for diabetic patients.

Effects of resveratrol therapy on glucose metabolism, insulin resistance, inflammation, and renal function in the elderly patients with type 2 diabetes mellitus: A randomized controlled clinical trial protocol

“…Diabetes mellitus is a chronic disorder that is characterized by insulin resistance and hyperglycemia and may lead to metabolic syndrome. [ 17 ] The elderly patients with diabetes frequently lead to f abnormal glucose metabolism and diabetic complications including nephropathy in these patients. [ 18 ] Resveratrol has antidiabetic properties, and few reports investigate its safety and efficacy in the treatment of elderly patients with diabetes.…”

Combination Therapy of Alpha-Lipoic Acid, Gliclazide and Ramipril Protects Against Development of Diabetic Cardiomyopathy via Inhibition of TGF-β/Smad Pathway

“…The focal point of the present study is our observation of marked degeneration and vacuolation of myocardial fibers in untreated diabetic rats, which positively correlated with elevated levels of cardiac damage markers such as troponin I (cTnI), creatine kinase myoglobin band (CK-MB) and brain natriuretic peptide (BNP) in plasma and heart tissue. cTnI and CK-MB are powerful biomarkers for sensitive and specific detection of cardiomyopathies such as DCM or cardiac injury from various causes while BNP is a non-specific but sensitive biomarker for predicting cardiac dysfunction including DCM ( Atabek et al, 2004 ; Korraa et al, 2012 ; El-Saiedi et al, 2020 ; Ajiboye et al, 2021 ). Thus, increased levels of these biomarkers predict the risk of cardiomyocyte death and subsequent adverse cardiac events.…”

Potential clinical biomarkers and perspectives in diabetic cardiomyopathy

“…Results from the study by Liu et al showed that in neonatal rat cardiomyocytes, pioglitazone prevented the increase in CT-l expression in high-glucose, high-insulin-induced hypertrophic cardiomyocytes, indicating that CT-1 is a major regulator of fat and glucose metabolism with potential applications in the treatment of obesity and IR [ 121 ]. 3D speckle-tracking echocardiography and tissue Doppler imaging were used in a clinical trial by Sonia et al [ 122 ], who compared 55 children with type 1 diabetes to 55 healthy controls and found that diabetic patients exhibited right ventricular and left ventricular systolic-diastolic dysfunction compared to controls. The best predictor of left ventricular systolic dysfunction was CT-1 (sensitivity: 69%).In an observational study of 93 patients with T2DM, Gamella-Pozuelo [ 123 ] discovered that diabetic patients had significantly higher plasma CT-1 levels and were more likely to have ventricular hypertrophy.…”