Risk Factors For Left Atrial Enlargement And Left Ventricular Diastolic Dysfunction In Patients With Type 2 Diabetes Mellitus

Objective:To preliminarily understand the present situation of left atrial enlargement and left ventricular diastolic dysfunction in patients with type 2 diabetes.To investigate the differences of gender,age,course of disease,BMI,waist to hip ratio,history of hypertension,history of smoking,family history of hypertension,random blood glucose,blood pressure,hemoglobin A1 c,fasting venous glucose,uric acid,creatinine,lipid,urinary albumin/creatinine,EF value,and anterior-posterior diameter in different echocardiographic groups.Furthermore,the risk factors related to the changes of cardiac ultrasound in patients with type 2 diabetes were analyzed in order to provide theoretical basis for the prevention and detection of early cardiovascular diseases in patients with diabetes.Methods:A total of 480 patients with type 2 diabetes who were admitted to the endocrinology department of chengde central hospital from November 2018 to June 2019 and who met the inclusion criteria were collected.Collecting the relevant clinical data: name,sex,be in hospital,age,course of diseases,height,weight,waist circumference,hip circumference,relevant medical history(history,smoking history,family history of high blood pressure),admission random glucose(tip),systolic pressure,diastolic blood pressure,height,weight,BMI,waist hip ratio,hemoglobin A1c(Hb A1c),uric acid,creatinine,triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL),high-density lipoprotein(HDL)cholesterol,fasting venous blood glucose(FPG),urine A/C,the EF values.The patients were divided into three groups according to the results of echocardiography,including the normal echocardiography group(group A),the left ventricular diastolic dysfunction group(group B),and the left atrial enlargement &left ventricular diastolic dysfunction group(group C).SPSS22.0 statistical software was used to compare the differences among the indicators among the three groups,and multivariate Logistic regression analysis was conducted to analyze the significant indicators among the groups and clinically related indicators,and to analyze the related risk factors of corresponding changes in cardiac ultrasound.The test level was set as 0.05,and P<0.05 indicated that the difference was statistically significant.Results:1.The comparison of general clinical data of three groups of patientsA total of 480 patients were collected in this study,including 130 in the normal echocardiographic group,100 in the left ventricular diastolic dysfunction group,and 250 in the the left atrial enlargement and left ventricular diastolic dysfunction group.Age,course of disease,systolic blood pressure,waist-hip ratio and the number of cases with hypertension increased gradually in the three groups,and the differences between the groups were statistically significant.There were statistically significant differences in gender among the three groups(P < 0.05),and there were no statistically significant differences in BMI,smoking history and family history among the three groups(P >,0.05).2.The comparison of laboratory and cardiac ultrasound data among three groups of patientsIn group A,B,and C,there were statistically significant differences in fasting venous blood glucose,EF,and anterior and posterior diameter of the left atrial(P< 0.05).Abnormal urine A/C,random blood glucose,hemoglobin a1 c,creatinine,uric acid,total cholesterol,triglyceride,LDL cholesterol and HDL cholesterol had no significant difference between groups(P >0.05).3.Multivariate Logistic regression was used to analysis the related factors of left ventricular dilatation and left ventricular diastolic dysfunctionMultivariate logistic regression analysis was performed,taking the presence of left atrial enlargement and left ventricular diastolic dysfunction as the dependent variable,and the age,course of disease,systolic blood pressure,BMI,waist-hip ratio,fasting venous blood glucose,hemoglobin a1 c,EF,and history of hypertension as independent variables,The results showed that age,BMI,waist-hip ratio,glycated hemoglobin,and history of hypertension were related risk factors for left atrial enlargement and left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus.Conclusion:1.In all cases,left atrial enlargement and left ventricular diastolic dysfunction on cardiac ultrasound accounted for 52.1%,indicating that in diabetes patients with no history of related heart disease,more than half of the patients will show abnormalities in early cardiac structure and function,which should be paid great attention by patients and clinicians.2.Age,BMI,waist to hip ratio,hemoglobin a1 c,and history of hypertension are risk factors for left atrial enlargement and left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus.Age is an uncontrollable factor,so it is necessary to actively control the factors,control blood pressure and blood glucose,weight loss,especially to improve abdominal obesity,may help delay the occurrence and development of cardiovascular complications.