Abstract
Background: Diabetes Mellitus is a significant risk factor for heart failure. With the increasing global prevalence of diabetes, diabetic cardiomyopathy (DCM) represents a significant public health issue. Elevated levels of Insulin-like growth factor-binding protein 7 (IGFBP7) is an early-stage biomarker in DCM but studies are lacking on the association between IGFBP7 and DCM. Most patients with DCM remain asymptomatic until late-stage disease, therefore it becomes of utmost importance to identify biomarkers to detect early stage of DCM. The aim of this study is to determine if IGFBP7 and other biomarkers can detect the onset of preclinical DCM relative to echocardiographic irregularities exhibiting diastolic dysfunction. Methods: Eighty patients were grouped equally into four categories based on predetermined clinical diabetic and cardiac parameters: Normal, Diabetes (DM), Diastolic Heart Failure (DHF) , and DM+DHF, the last group being the preclinical DCM group. Results: Echocardiography images indicated severe diastolic dysfunction in patients with DHF + DM as compared to DHF patients alone. In the DM and DM+DHF groups, IL-6, TNF-alpha, isoprostane, and leptin were elevated compared to the control, as were clinical markers HDL, glucose and hemoglobin A1C. More importantly fibrotic markers IGFBP7 and TGF-β followed the same trend . The Normal group showed higher levels of beneficial biomarkers adiponectin and bilirubin, which were reduced in the DM and DM+DHF groups. Conclusion: This novel study demonstrates that West Virginia patients with early onset DCM were more likely to have elevated levels of detrimental biomarkers, including IGFBP7 and TGF- β, indicating potential diastolic dysfunction. The present study provides new and exciting evidence supporting the potential clinical applications of using IGFBP7 and other biomarkers in diagnosing early stage DCM in the West Virginia population.
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