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Association of Glycosylated Haemoglobin (HbA1c) Level With Left Ventricular Diastolic Dysfunction in Patients With
Rishi T Guria1, Manoj K Prasad2, Brajesh Mishra3
1Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND.
Insights
High glycosylated hemoglobin (HbA1c) levels are associated with an increased risk of left ventricular diastolic dysfunction (LVDD) in type 2 diabetes patients. Early screening for LVDD in diabetic individuals is crucial for preventing severe complications.
Area of Science:
- Cardiology
- Endocrinology
- Diabetology
Background:
- Type 2 diabetes mellitus is linked to a high prevalence of pre-clinical diastolic dysfunction.
- Glycosylated hemoglobin (HbA1c) is a key indicator of glycemic control in diabetes.
Purpose of the Study:
- To determine the association between HbA1c levels and left ventricular diastolic dysfunction (LVDD) in type 2 diabetes patients.
- To investigate the predictive value of HbA1c for LVDD in this population.
Main Methods:
- An observational cross-sectional study involving 100 type 2 diabetes mellitus patients.
- Logistic regression and multivariable logistic regression analyses were performed.
- Doppler echocardiography was used to assess left ventricular diastolic function.
Main Results:
- Patients with LVDD had significantly higher mean HbA1c levels (11.07 ± 3.66%) compared to those without LVDD (9.11 ± 2.95%).
- Higher HbA1c was independently associated with LVDD (OR 1.26, 95% CI 1.08-1.48).
- Longer diabetes duration also significantly predicted LVDD (OR 1.48, 95% CI 1.20-1.82).
Conclusions:
- Elevated HbA1c levels are a significant risk factor for LVDD in type 2 diabetes.
- Timely screening for LVDD using Doppler echocardiography in asymptomatic diabetic patients is recommended.
- Early detection and management of LVDD can reduce morbidity and mortality in diabetic patients.
Abstract:
Background Some literature has shown a high prevalence of pre-clinical diastolic dysfunction in subjects with type 2 diabetes mellitus. The current study was carried out to determine the association of glycosylated hemoglobin (HbA1c) levels with left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes. Methods An observational cross-sectional study was conducted in a tertiary health care center in Jharkhand. A total of 100 subjects diagnosed with type 2 diabetes mellitus who gave informed consent and fulfilled the inclusion and exclusion criteria were studied in our center from April 2019 to September 2020. Logistic regression was carried out to determine the association of potential variables with outcomes. Multivariable logistic regression analysis was conducted to determine the independent effects of variables for LVDD prediction. Results The mean HbA1c of the population with LVDD was found to be higher (11.07 ± 3.66%) as compared to the population with normal LVDD (9.11 ± 2.95%), which was found statistically significant (probability value (P) =0.004). This signifies that a higher level of HbA1c in a patient with diabetes will have a higher incidence of LVDD. On applying multivariate analysis to determine the independent effect of variables for LVDD, HbA1C was found to be significant with an odds ratio (OR) of 1.26, 95% CI 1.08-1.48. The duration of diabetes was also found to be significant with OR 1.48 and CI 95 % (1.20-1.82) P <0.001. On plotting the receiver operating characteristic curve (ROC), the area under the ROC curve to predict the left ventricular function with the model was 0.8137. Conclusions Patients who have higher HbA1C are linked to a higher risk of left ventricular diastolic dysfunction in patients with type 2 diabetes. The combination of diabetes and left ventricular dysfunction can lead to increase morbidity and mortality in those patients in whom it is not identified timely and appropriate measures are not taken. Our work emphasizes the requirement of screening intermittently symptomless diabetic patients for diastolic dysfunction through a Doppler echocardiography so that timely action can be taken.
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