Endocrine Abstracts

Background: Аgrowing body of evidence suggests that type 2 diabetes mellitus (T2DM) may contribute to the the development and deterioration of heart failure (HF) with either reduced or preserved ejection fraction. On the other hand, diabetic kidney disease (DKD) is associated with a high risk and worsе outcomes of HF. However, the relationship between DKD and various types of HF hasn’t been fully investigated. The aim of this study was to assess the association between the signs of DKD and different types of HF in patients with T2DM.

Methods: Three groups of patients with T2DM were examined. The first group included 20 patients with T2DM and no HF. (age - 62.6±10.0 years, mean diabetes duration - 3.9±2.5 years, HbA1c - 7.0±1.2%, creatinine - 99.0±19.0 µ mol/l, estimated glomerular filtration rate (eGFR) - 64.0±16.0 ml/min/1.73m², albumin/creatinine ratio (ACR) - 25.0±21.0 mg/g, ejection fraction (EF) - 58.0±4.0%.(data are presented as mean±SD). The second group included 15 patients with T2DM and HF with reduced EF (HFrEF). (age 66.0±7.0 years, mean diabetes duration - 4.0±2.0 years, HbA1c - 6.9±0.7%, creatinine - 122.0±26.0 µ mol/l, eGFR - 48.0±9.0 mL/min/1.73m², ACR - 76.0±73.0 mg/g, EF - 34.0±10.0%). The third group included 15 patients with T2DM and HF with preserved EF (HFprEF). (age - 67.0±9.0 years, mean diabetes duration - 5.0±2.0 years, HbA1c - 7.0±2.0%, creatinine - 130.0±52.0 µ mol/l, eGFR - 48.0±18.0 mL/min/1.73m², ACR - 115.0±110.0 mg/g, EF -55.0±3.0%). The ACR in urine and eGFR were recorded and compared among these three groups using Student’s t-test.

Results: We found that the eGFR levels were significantly lower in patients with T2DM and HFprEF compared to patients without HF and patients with HFrEF (48.0±18.0; 64.0±16.0; 48.0±9.0, –respectively, P<0.05). Also the ACR was significantly higher in patients with T2DM and HFprEF compared to patients without HF and patients with HFrEF (115.0±110.0; 25.0±21.0; 76.0±73.0, –respectively, P<0.05)

Conclusion: We found that the signs of DKD were the most pronounced in the group of patients with T2DM and HFprEF, which could suggest an important role of DKD in the pathogenesis of HFpEF in patients with T2DM.