Abstract
Background. Diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM) is associated with a risk of developing chronic heart failure (CHF). The degree of albuminuria is a marker of DN and is associated with an increased risk of chronic heart failure (CHF).Aim. To evaluate fibrosis biomarkers and echocardiographic parameters in patients with T2DM without CHF, depending on urinary albumin excretion.Materials and methods. The study included 42 patients with T2DM without verified CHF. The patients were divided into two groups: 1) a group with normoalbuminuria and 2) a group with a moderate increase in albuminuria (albumin / creatinine ratio of 30–300 mg / g). Echocardiography was performed and galectin-3, ST-2, PIСP, MMP-9, and TIMP-1 concentrations were measured.Results. The groups did not differ by age, sex, body mass index (BMI), glycated hemoglobin (HbA1c), and glomerular filtration rate (GFR). Galectin-3 concentrations were significantly higher in the group with a moderate increase in albuminuria than in the group of patients without albuminuria – 13.6 (11.2; 15.1) ng / ml and 7.4 (6.7; 7.9) ng / ml, respectively, p = 0.002. The groups also did not differ in the values of biomarkers, such as P1CP, TIMP-1, and MMP-9. Besides, the group with normoalbuminuria had lower E/e’ values than the group with a moderate increase in albuminuria – 8 (7; 9) and 10 (9; 12.5), p = 0.02.Conclusion. The patients with type 2 diabetes and a moderate increase in albuminuria have higher values of galectin-3 and a more pronounced diastolic dysfunction. The identified changes may reflect a higher risk of chronic heart failure in this group of patients.
Highlights
Diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM) is associated with a risk of developing chronic heart failure (CHF)
The identified changes may reflect a higher risk of chronic heart failure in this group of patients
Сотрудник, лаборатория диабетологии, Институт эндокринологии, НМИЦ им
Summary
Наличие диабетической нефропатии (ДН) у пациентов с сахарным диабетом 2-го типа (СД2) ассоциировано с риском развития хронической сердечной недостаточности (ХСН). В исследование были включены 42 пациентов с СД2 без установленного диагноза ХСН. Пациенты были разделены на группы: с нормальной альбуминурией и с умеренным повышением альбуминурии (альбумин/креатининовое соотношение 30–300 мг/г). Концентрации галектина-3 были значимо выше в группе с умеренным повышением альбуминурии – 13,6 (11,2; 15,1) нг/мл и 7,4 (6,7; 7,9) нг/мл соответственно, р = 0,002. Группа с нормоальбуминурией имела меньшие значения E/e’, чем группа с умеренным повышением альбуминурии – 8 (7; 9) и 10 (9; 12,5), р = 0,02. Пациенты с СД2 и умеренным повышением альбуминурии имеют большие значения галектина-3 и более выраженное нарушение диастолической функции сердца, чем пациенты с нормоальбумин урией. Маркеры фиброза и эхокардиографические параметры у пациентов с сахарным диабетом 2-го типа в зависимости от уровня альбуминурии.
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