(2.01) Correlation of Diastolic Dysfunction with Albuminuria in Type 2 diabetes mellitus

Albuminuria has been shown to predict Endothelial dysfunction & cardiovascular morbidity in persons with diabetes mellitus independent of other CV risk factors like age, Hypertension, & dyslipidemia.

Methods:

This was a case control study of 120 patients with Diabetes. Study group included 60 patients with diabetes having urine ACR >30 mg/g measured on 2 separate occasions and control group included 60 patients with diabetes having urine ACR < 30mg/g, while all patients had normal KFT.  Both the groups were matched for age, gender, Hypertension, HBA1C, dyslipidemia.  Detailed clinical history recorded.  These patients were also screened for diabetic retinopathy and diabetic neuropathy status. All patients underwent 2-Decho with pulse wave Doppler and echo derived parameters of LV diastolic dysfunction were recorded.

Results:

Proportion of patients with LV diastolic dysfunction was significantly higher in the study group as compared to control group. Study revealed 78% patients to have diastolic dysfunction as compared to 18% in control group. Gradual increase in severity of diastolic dysfunction from no albuminuria group to microalbuminuria and macro albuminuria group was observed. Significant positive correlation was seen between albuminuria and diastolic dysfunction with p value < 0.001.

Discussion/Conclusion:

This study points towards significant increase in diastolic dysfunction and grade among the patients with diabetes with albuminuria compared to patients with diabetes but without albuminuria. So urine ACR can be used as a sensitive bio marker for predicting diastolic dysfunction in patients with diabetes. Therefore, screening for microalbuminuria in diabetes patients could identify individuals having worsening diastolic dysfunction at a very early stage.