PMID- 37954809
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231122
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 10
DP  - 2023 Oct
TI  - Factors Affecting Biochemical and Echocardiographic Indices in Type 2 Diabetes 
      Mellitus Patients Without Overt Symptoms of Heart Failure: A Cross-Sectional 
      Study.
PG  - e46904
LID - 10.7759/cureus.46904 [doi]
LID - e46904
AB  - Introduction Diabetes is a known risk factor for heart failure (HF), and HF often 
      manifests as a common cardiovascular event in people with type-2 diabetes 
      mellitus (T2DM). Once HF is present, diabetes presents an especially adverse 
      prognosis for subsequent morbidity and mortality. Brain natriuretic peptide (BNP) 
      and n-terminal ProBNP (NT-proBNP) are used as diagnostic biomarkers for HF that 
      are secreted by the ventricles in response to increased myocardial wall stress. 
      If we could unmask some clinical and routine laboratory parameters affecting BNP 
      and ejection fraction (EF), we can predict impending HF and take measures to 
      prevent it. The current study was conducted to investigate the factors affecting 
      BNP and EF for detecting potential HF in T2DM patients who do not exhibit overt 
      HF symptoms. Materials and methods The present cross-sectional study was 
      performed after obtaining ethical clearance from the Institutional Ethics 
      Committee. T2DM patients consulting the Medicine Outpatient Department (OPD) of 
      BRD Medical College Gorakhpur during a two-month period (from 20 July 2023 to 19 
      September 2023) with age >40 years and duration of T2DM >10 years. Multistage 
      random sampling was done to recruit study participants, and 308 patients 
      participated in the study. Informed consent was obtained from the recruited 
      participants. The chi-square or Fisher's exact test (whichever was applicable) 
      was used to explore the association between categorical variables. Correlation 
      statistics were calculated using Spearman correlation among the NT-proBNP, EF, 
      and other relevant variables. The Statistical Package for Social Sciences (SPSS) 
      (version 21; IBM SPSS Statistics for Windows, Armonk, NY) was used for the 
      analysis, and a two-sided p-value of < 0.05 was considered significant. Results 
      Three hundred and eight diabetic patients satisfying inclusion and exclusion 
      criteria were enrolled as study participants and completed the study. The mean 
      age of the total study subjects was 60.82 +/- 9.23 years. There were 161 (52.3%) 
      male and 147 (47.7%) female participants, and about half (153/308, 49.7%) of the 
      participants belonged to the age group 40-60 years. There was a statistically 
      significant association (p = 0.01) between NT-proBNP and glycated hemoglobin. 
      Statistically highly significant (p < 0.001) associations were found between 
      NT-proBNP with duration of T2DM and EF. There was a strong negative correlation 
      (correlation coefficient = -0.743) between EF and NT-proBNP, and this correlation 
      was statistically highly significant with a p-value < 0.001. Conclusion Elevated 
      NT-proBNP levels and impaired EF were found in a significant proportion of these 
      patients, indicating an increased risk of cardiovascular complications. This 
      study highlights a significant association between NT-proBNP and EF in patients 
      with T2DM in those without overt heart failure symptoms. Furthermore, longer T2DM 
      duration and higher HbA1c levels were found to be associated with elevated 
      NT-proBNP levels, while longer T2DM duration and elevated NT-proBNP were linked 
      to lower EF. These findings have important clinical implications, as they suggest 
      that monitoring NT-proBNP levels in patients with T2DM without clinical features 
      of overt heart failure may help identify those at risk for decreased EF and 
      potentially prevent heart failure.
CI  - Copyright (c) 2023, Singh et al.
FAU - Singh, Raj Kishore
AU  - Singh RK
AD  - Medicine, Baba Raghav Das Medical College, Gorakhpur, IND.
FAU - Singh, Kunal Kumar
AU  - Singh KK
AD  - Cardiology, Baba Raghav Das Medical College, Gorakhpur, IND.
FAU - Singh, Aradhana
AU  - Singh A
AD  - Obstetrics and Gynaecology, All India Institute of Medical Sciences, Gorakhpur, 
      Gorakhpur, IND.
FAU - Khan, Imran Ahmed
AU  - Khan IA
AD  - Community Medicine, Baba Raghav Das Medical College, Gorakhpur, IND.
FAU - Yadav, Subhash C
AU  - Yadav SC
AD  - Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 
      IND.
LA  - eng
PT  - Journal Article
DEP - 20231012
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10636655
OTO - NOTNLM
OT  - diabetes mellitus
OT  - glycemic control
OT  - heart failure
OT  - natriuretic peptide
OT  - prognosis
OT  - risk factor
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/11/13 06:42
MHDA- 2023/11/13 06:43
PMCR- 2023/10/12
CRDT- 2023/11/13 04:37
PHST- 2023/10/12 00:00 [accepted]
PHST- 2023/11/13 06:43 [medline]
PHST- 2023/11/13 06:42 [pubmed]
PHST- 2023/11/13 04:37 [entrez]
PHST- 2023/10/12 00:00 [pmc-release]
AID - 10.7759/cureus.46904 [doi]
PST - epublish
SO  - Cureus. 2023 Oct 12;15(10):e46904. doi: 10.7759/cureus.46904. eCollection 2023 
      Oct.