Endocrine Abstracts

Introduction: The prevalence of left ventricular hypertrophy (LVH) is high among patients with chronic kidney disease (CKD) and associated with a lower cardiac functional status, particularly in patients with diabetes mellitus (DM). The aim of the study was to estimate prevalence of LVH and to define factors influencing to development of LVH in patients with diabetic nephropathy (DN).

Methods: patients with type 2 DM were studied - 22 males, 43 females, mean age 53.717.4.21 patients had normal renal function with mean hemoglobin (Hb) 13.72.0 g/dl, 44 patients had chronic renal failure (CRF) with decreased mean GFR 46.723.7 ml/min/1.73 m²/ and Hb 11.82.4 g/dl (P<0.05). Glomerular filtration rate (GFR) was calculated using the Cockcroft-Gault formula. Anemia was defined as hemoglobin (Hb) < 13 g/dl in men and < 12 g/dl for women by the definition of WHO. 62 patients had arterial hypertension. Patients on dialysis were not included.

Results: LVH (left ventricular mass index (LVMI) > 134 g/m² for men and > 110 g/m² for women) was found in 50 DN patients (77.6%). At GFR < 30 ml/min/1.73 m² the prevalence of LVH was 100%. Concentric hypertrophy of left ventricular (LV) was found in 51% patients, eccentric LV hypertrophy in 26.5% patients, 14.3% patients had concentric remodeling of LV, 8.2% - were with normal geometry of LV. The LVMI is significantly associated with older age (R=0.43, P<0.01), Hb (R=−0.44, P<0.05), GFR (R=−0.29, P<0.05). Independent factors affecting on development of LVH in patients with DN by multiple logistic regression analysis were Hb level and value of systolic blood pressure (P=0.0003).

Conclusions: We conclude that prevalence of LVH was higher in patients with type 2 diabetes, with impaired renal function. Anemia and systolic blood pressure were independent factors influencing on development of LVH in patients with DN.