A study of high serum calcium level in diabetes mellitus and its association with left ventricular remodeling

ABSTRACT

Background: Hypocalcemia is one of the important complications of diabetes mellitus. It occurs when the patient develops renal insufficiency but hypercalcemia occurs in diabetes due to many mechanisms including insulin resistance. Meanwhile, hypercalcemia itself produces insulin resistance and the calcium is the important one for the production of insulin and glucose uptake in the cells. Aim of the study To assess left ventricular dimension and wall thickness mass in diabetic patients having high serum calcium level. Materials and methods: This study was conducted in Government Royapettah Hospital, Chennai for duration of 6 months from April 2018 to September 2018. 2016 patients were enrolled in the study. After obtaining an informed written consent, demographic details, past medical history and clinical examination was done. Following investigation was done in all patients. Serum calcium, serum creatinine, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose was done. 2D ECHO – echocardiography was done in all patients. In left lateral position ECHO was performed in parasternal long axis, 4 chamber view. M mode was used to assess the septal wall, posterior wall thickness and left ventricular diastolic dimension. By using wall thickness left ventricular mass is calculated. Results: According to our serum calcium was main Determinator of left ventricular remodeling by many mechanisms. Serum calcium was > 10.2 in LVH group people but in non-LVH group people serum calcium level was within the normal limit that was given as < 10.2 mg/dl. 1 patient in non-LVH group was having high serum calcium but does not make statistical changes in that group. The mean serum calcium of LVH group was 10.6mg/dl. D. Venkateswarlu, M. Praveen Kumar. A study of high serum calcium level in diabetes mellitus and its association with left ventricular remodeling. IAIM, 2019; 6(9) 66-71. Page 67 Conclusion: Normal calcium mandatory for excitation-contraction coupling but high calcium adversely affect the ECC and produces ventricular dysfunction and through neurohormonal mechanism it produces cardiac muscle hypertrophy. According to this study increased serum calcium in diabetes has strong correlation with occurrence of cardiac remodeling.