Cardiac troponin I concentrations in people presenting with diabetic ketoacidosis.
BACKGROUND
Elevated troponin concentrations may be observed in a wide spectrum of medical disorders in people without evidence of overt ischaemic heart disease. The prospective relationship between serum cardiac troponin I (cTnI) and diabetic ketoacidosis (DKA) has not been examined in adults.


METHODS
Forty patients (14 male and 26 female) with type 1 diabetes were recruited. cTnI, creatine kinase (CK), cystatin C and beta-hydroxybutyrate were measured on admission and at 24, 48 and 72 h post-admission. Daily electrocardiographs were also performed.


RESULTS
Four out of forty subjects presenting with DKA had an increase in cTnI (median (SD) 0.06 (0.31) microg/L). One of the subjects had multiple possible reasons for the elevated cTnI concentration. However, the other three subjects had no obvious precipitating factors. This cohort underwent echocardiography and thallium-201 scintigraphy, which revealed no abnormalities.


CONCLUSIONS
Minor troponin elevations appear to occur in a small number of subjects with type 1 diabetes presenting with DKA. The clinical relevance of this at this stage remains unknown and further large-scale studies are suggested.
Geddes
J
J
Department of Diabetes, Glasgow Royal Infirmary, Glasgow, Scotland, UK.
Deans
K A
KA
Cormack
A
A
Motherwell
D
D
Paterson
K
K
O'Reilly
D St J
DS
Fisher
B M
BM
D020155:3-Hydroxybutyric Acid / Q000097:blood; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003402:Creatine Kinase / Q000097:blood; D055316:Cystatin C; D015891:Cystatins / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000097:blood*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D019210:Troponin I; D020107:Troponin T; D003402:Creatine Kinase; D020155:3-Hydroxybutyric Acid