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Intersecting Endocrine Pathways in Cardiomyopathy: The Role of Metabolic Burden in Structural Heart Disease

Ovidiu Țica1,2, Mircea Ioan Șandor3, Anca Huniadi3

  • 1Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.

Biomedicines
|October 29, 2025
PubMed

Insights

Non-insulin-treated diabetes and hypothyroidism significantly increase the risk of dilated cardiomyopathy (DCM). A metabolic burden score combining these factors aids in stratifying DCM and readmission risk.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Dilated cardiomyopathy (DCM) is a primary cause of heart failure morbidity and mortality.
  • The combined impact of type 2 diabetes mellitus (T2DM), obesity, and thyroid dysfunction on DCM is not well understood.
  • These conditions are individually linked to cardiovascular disease.

Purpose of the Study:

  • To assess the independent and combined associations of diabetes, thyroid dysfunction, and obesity with DCM prevalence.
  • To evaluate the impact of these metabolic factors on 30-day hospital readmission rates.
  • To examine the utility of a composite Metabolic Burden Score for risk stratification.

Main Methods:

  • Retrospective analysis of 1079 adult patients' electronic health records.
  • Multivariable logistic regression with ridge regularization to identify DCM predictors.
  • Stratification of endocrine phenotypes and development of a 3-point Metabolic Burden Score.

Main Results:

  • DCM prevalence was 46%; non-insulin-treated diabetes (OR 6.93) and hypothyroidism (OR 1.78) were independent predictors.
  • Obesity contributed to DCM risk within the Metabolic Burden Score.
  • DCM prevalence increased with the score, reaching 50% in the high-risk group; moderate-risk patients had the highest readmission rate (42.8%).

Conclusions:

  • Non-insulin-treated diabetes and hypothyroidism are significant metabolic drivers of DCM.
  • A composite Metabolic Burden Score effectively stratifies risk for DCM and early hospital readmission.
  • Integrated endocrine-cardiac screening can improve early detection and prevention of structural heart disease.

Keywords:
cardiovascular riskdiabetes mellitusdilated cardiomyopathyendocrine comorbidityhospital readmissionmetabolic burdenobesitythyroid dysfunction

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