Correlation between insulin resistance and cardiac function inpatients with type 2 diabetes mellitus / 中国糖尿病杂志

ABSTRACT

Objective To compare the cardiac function in patients with type 2 diabetes (T2DM) and insulin resistance(IR),and analyze the correlation between IR and cardiac function.Methods A total of 282 patients with T2DM were enrolled randomly in this study from our clinic and ward from Aug.2015 to Aug.2016.All the subjects were divided into two groups according to the level of HOMA-IRHOMA-IR ＜2.69 group(n=153) and HOMA-IR≥2.69 group(n=129).Healthy subjects were selected as the normal control group (NC group,n=150).The clinical data and biochemical index were collected in all the subjects.The cardiac function index included LVPWTd,WsTd,LVSV,LVFS and LVEF were tested and compared among the three groups.Pearson's correlation analysis was used to evaluate the correlation between HOMA-IR and cardiac function index.Multiple stepwise linear regression was adopted to analyze the influencing factors for cardiac systolic function(LVEF) and diastolic function(E/A).Results (1) FPG,2 hPG and FIns decreased,while HOMA-β increased from HOMA-IR≥ 2.69 group,HOMA-IR＜ 2.69group to NC group (P＜0.05 or P＜0.01);(2) LVPWTd [(15.43±1.92) vs (11.38±1.78) vs (10.16±1.50) mm,P＜0.05 or P＜0.01)and WSTd [(14.35±2.00) vs (10.46±1.67) vs (9.00±1.08) mm,P＜0.05 or P＜0.01)were higher in HOMA-IR≥2.69 group and HOMA-IR＜2.69 group than in NC group.LVSV[(55.15±8.26)％ vs (60.27±8.12)％ vs (65.33±7.78)％,P＜0.05 or P＜0.01],LVEF [(62.41±8.89)％ vs (71.57±5.16)％ vs (76.35±7.80)％,P＜0.05 or P＜0.01],and E/A[(0.65±0.11) vs (0.76±0.18) vs (1.03±0.23),P＜0.05 or P＜0.01] were lower in HOMA-IR≥2.69 group and HOMA-IR＜2.69 group than in NC group.(3)Pearson correlation analysis showed that HOMA-IR was negatively correlated with LVEF and E/A(r=-0.746,-0.729,P=0.001).(4) Multiple stepwise linear regression analysis showed that HOMA-IR was an influencing factor for LVEF and E/A(P＜0.05 or P＜0.01).Conclusion With the aggravating of IR,LVEF and E/A are declined in diabetic patients.IR is a common risk factor for LVEF and E/A.