| Objective:Type 2 diabetes mellitus can be complicated by structural changes and functional abnormalities of the heart,and echocardiography can monitor the corresponding indicators.Numerous studies have demonstrated that Time In Range,an indicator in ambulatory glucose monitoring,is associated with chronic complications of T2 DM.In this study,the TIR measured by ambulatory glucose monitoring was used as a grouping basis,and the main parameters of heart structure and function measured by echocardiography were used as quantitative indicators of cardiovascular disease,and the correlation between ambulatory glucose monitoring indicators and changes in the main parameters of echocardiography in T2 DM patients was studied,aiming to provide a basis for the early prevention and treatment of cardiovascular diseases in T2 DM patients.Method:A case-control study was conducted to collect clinical data of T2 DM patients who were hospitalized in the Department of Endocrinology and had ambulatory glucose monitoring in the 967 th Hospital of the Joint Logistics Support Force of People’s Liberation Army of China from March 2021 to December 2022,in which cardiac ultrasound data were completed by two experienced ultrasonographers in the 967 th Hospital of the Joint Logistics Support Force of People’s Liberation Army of China.The general data,main biochemical indexes,urinary microalbumin/creatinine ratio,ambulatory glucose monitoring indexes and echocardiographic indexes of the two groups were compared and statistically analyzed.Result: 1.A total of 76 patients with T2 DM were included in this study,including 31 cases in the group with non-compliant blood glucose and 45 cases in the group with compliant blood glucose.The differences in age,BMI,blood pressure at admission,duration of hypertension,duration of coronary artery disease,gender composition ratio,smoking history,application of glucose-lowering regimens with cardioprotective effects,and history of atherosclerosis between the two groups were not statistically significant(P > 0.05).The mean BMI in both groups was higher than the upper limit of the normal range(24.0 kg/m2),the mean systolic blood pressure in both groups was higher than the target value for systolic blood pressure control in T2DM(<130 mm Hg),and the proportion of patients with combined neck and/or lower extremity atherosclerosis in both groups was more than half,and the proportion in the group with substandard blood glucose was 90.3% and the proportion in the group with standard blood glucose was 84.4%.The median duration of diabetes was 120 months in the group with non-compliant blood glucose and 84 months in the group with compliant blood glucose,and the difference between the two groups was statistically significant(P < 0.05).2.The differences in fasting C-peptide,postprandial C-peptide,postprandial insulin,TG,TC,HDL-C,LDL-C,urea nitrogen,creatinine,glomerular filtration rate,blood uric acid,cystatin C,D-dimer,and urine microalbumin creatinine ratio were not statistically significant(P > 0.05)when comparing the two groups.The median fasting glucose,postprandial glucose and Hb A1 c were higher than the normal range and higher than the control target in both groups,and the difference between the two groups was statistically significant(P < 0.05).3.When comparing the TBR of the two groups,the difference was not statistically significant(P > 0.05),and the median TAR and mean glucose values of the group with unmet blood glucose were higher than those of the group with met blood glucose,and the difference was statistically significant(P < 0.05).4.There was no statistically significant difference between the two groups in terms of cardiac structural indexes(left atrial internal diameter,left ventricular end-systolic and end-diastolic short diameter,left ventricular end-systolic and end-diastolic long diameter)and cardiac systolic function indexes(LVEF,LVFS,s’)(P > 0.05).The median left ventricular end-diastolic short diameter and cardiac systolic function indexes were within the normal range in both groups.The cardiac diastolic function index e’ was 5.80 cm/s in the group with non-compliant blood glucose and 6.20 cm/s in the group with compliant blood glucose,both of which were lower than the normal limit(>7 cm/s),and the difference was statistically significant(P < 0.05).5.Spearman’s correlation analysis showed that e’ in T2 DM patients was negatively correlated with diabetes duration(r =-0.351,P = 0.002),positively correlated with TIR(r = 0.327,P = 0.004),negatively correlated with TAR(r =-0.290,P = 0.011),and negatively correlated with glucose mean(r =-0.283,P = 0.013).(The duration of diabetes was negatively correlated with TIR(r =-0.235,P = 0.041);the mean glucose was positively correlated with Hb A1c(r = 0.592,P = 0.000).Conclusion: 1.Patients with T2 DM with substandard glycemic control have a longer duration of diabetes and poorer cardiac diastolic function compared to those with standard glycemic control.2.Patients with T2 DM are prone to complications of abnormal cardiac diastolic function.e’ is positively correlated with TIR and negatively correlated with TAR and glucose mean in patients with T2 DM,and blood glucose should be actively controlled to increase TIR.duration of diabetes is negatively correlated with TIR and e’.3.Combined with ambulatory glucose testing and echocardiographic diagnostic indicators,it is beneficial for the early diagnosis and prevention of T2DM-related cardiovascular diseases. |
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