Increased cardiac troponin I concentration in diabetic ketoacidosis.
OBJECTIVE
To examine the hypothesis that diabetic ketoacidosis may be associated with some degree of induced injury to heart muscle, related either to acidosis or hyperglycemia.


METHODS
Nineteen diabetic patients with acute ketoacidosis and 19 healthy children were enrolled in this study. Cardiac troponin I (cTnI), creatine kinase (CK)-MB and myoglobin levels were analyzed soon after admission and after 24 h. Patients were subdivided into two groups according to blood pH.


RESULTS
At the time of admission, the diabetic patients had significantly higher values than the controls for cTnI (0.193+/-0.008 vs 0.176+/-0.006 ng/dl; p <0.001), CK-MB (24.1+/-2.1 vs 22.7+/-1.2 U/l; p = 0.02), and myoglobin (85.5+/-7.4 vs 52.5 +/-8.3 microg/dl; p <0.001). The diabetic patients also had significantly higher values than the controls for CK-MB (24+/-2.1 vs 22.7+/-1.2 U/l; p = 0.02) and for myoglobin (78.5+/-2.5 vs 52.5+/-8.3 microg/dl; p <0.001) at 24 h. cTnI had normalized in patients at 24 h. All parameters were significantly different between patients with pH > or =7.0 and patients with pH <7.0. In addition, serum cTnI levels correlated negatively with blood pH (r = -0.57, p = 0.026) and HCO3- (r = -0.65, p = 0.008) in the patients with diabetic ketoacidosis on admission.


CONCLUSIONS
Our findings suggest that diabetic ketoacidosis, particularly when severe, has a detrimental effect on the myocardium.
Atabek
Mehmet Emre
ME
Department of Pediatrics, Selcuk University, Faculty of Medicine, Konya, Turkey. meatabek@hotmail.com
Pirgon
Ozgur
O
Oran
Bülent
B
Erkul
Ibrahim
I
Kurtoglu
Selim
S
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000097:blood* / Q000209:etiology; D002648:Child; D016883:Diabetic Ketoacidosis / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006943:Hyperglycemia / Q000097:blood / Q000150:complications; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D009211:Myoglobin / Q000097:blood*; D012016:Reference Values; D018709:Statistics, Nonparametric; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D009211:Myoglobin; D019210:Troponin I