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Purpose Many studies have shown that subclinical left ventricular systolic dysfunction is seen in prediabetic patients.However,its relationship with prognosis is unclear.The purpose of this study is to investigate the prognostic value of subclinical left ventricular systolic dysfunction with prediabetes.Materials and Methods This was a prospective clinical cohort study.A total of 98 prediabetes patients with complete medical record and follow up data in the physical exam center and the clinic of Yan'an People's Hospital were chosen between January 2013 and January 2014.The biochemical data,echocardiography and left ventricular global longitudinal strain (GLS) in 2 years of follow up were collected.The subjects were grouped into diabetes if the diagnosis was confirmed during follow up,or non-diabetes group if not diagnosed.After follow up,the baseline parameters were compared to screen for risk factors to develop clinical diabetes.Results During the study,38 participants were diagnosed as clinical diabetes.Cox proportional hazard regression models show that obesity [hazard ratio (HR):2.662,95％ CI 1.374-5.159,P=0.004],waist-hip ratio (HR:1.917,95％ CI:1.012-3.492,P=0.001),mitral E/e'ratio (HR:1.661,95％ CI:1.336-2.065,P＜0.001),HbAlc (HR:2.029,95％ CI:1.047-3.932,P＜0.001),global longitudinal strain (HR:0.786,95％ CI:0.728-0.848,P＜0.001) were significant independent predictors for developing diabetes.Using GLS＜18％ as cutoff value,the area under receiver operating characteristic (ROC) curve to predict development of diabetes was 0.796 (95％ CI:0.704-0.888,P＜0.001),with sensitivity and specificity of 46.7％ and 89.5％,respectively.Conclusion Among modifiable risk factors in patients with prediabetes,subclinical left ventricular systolic dysfunction is an early indicator of progressing to diabetes.Early detection of left ventricular systolic dysfunction in prediabetes can provide the basis for early clinical intervention.
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Objective:To explore protective effect of atorvastatin on blood vessels in early stage of atherosclerosis (AS).Methods:A total of 120 patients without AS plaques,who had >2 cardiovascular risk factors and received control cardiovascular risk factors therapy,were randomly divided into four groups:control group (did not receive atorvastatin),atorvastatin 5mg group,10mg group and 20mg group (received corresponding dose of atorvastatin). All patients were followed up for six months,changes of thromboxane B2 (TXB2),6-Keto-prostaglandin F1α (6-Keto-PGF1α),brachial-ankle pulse wave velocity (baPWV),ankle brachial index (ABI)and intima-media thickness (IMT)were observed.Results:There were no significant changes in ABI and IMT between before and after treat-ment among four groups (P >0.05 all).Compared with baseline,TXB2、baPWV levels significantly rose,6-Keto-PGF1αlevel significantly decreased after treatment in control group and 5mg group;in contrast,TXB2、baPWV lev-els significantly decreased,6-Keto-PGF1αlevel significantly rose after treatment in 10mg group and 20mg group(P <0.05~ < 0.01).After treatment six-month,compared with control group and 5mg group,the TXB2 [(148.3 ± 29.2)pg/ml,(142.3±30.6)pg/ml vs.(111.5±22.8)pg/ml,(104.9 ± 17.4)pg/ml]、baPWV[(1621.1 ± 136.1) cm/s,(1597.7±125.3)cm/s vs.(1232.9±132.3)cm/s,(1178.2±155.1)cm/s]levels significantly decreased,6-Keto-PGF1α[(104.7±66.1)pg/ml,(102.2±70.3)pg/ml vs.(132.8±48.3)pg/ml,(139.1±66.3)pg/ml]level significantly rose(P <0.05~<0.01)in 10 mg group and 20 mg group.Conclusion:Atorvastatin has protective effect on blood vessels in early stage of atherosclerosis,and 10mg atorvastatin may be the minimum effective dosage to protect blood vessels.