title: Predictors of early-stage left ventricular dysfunction in type 2 diabetes: results of DYDA study.
abstract: BACKGROUND
  Better knowledge of prevalence and early-stage determinants of subclinical left ventricular dysfunction (LVD) in type 2 diabetes would be useful to design prevention strategies. The objective of the LVD in Diabetes (DYDA) study was to assess these points in patients without established cardiac disease.
  
  
  METHODS
  Baseline clinical, ECG, laboratory and echocardiographic data from 751 patients (61 ± 7 years, 59% hypertensive) recruited by 37 Italian diabetes clinics were analysed. Clinical history, life habits, laboratory data (NT-proBNP, HsCRP, HbA1c, serum glucose, lipids and creatinine, liver enzymes, microalbuminuria, glomerular filtrate) and data on microvascular complications and drug therapy were collected.
  
  
  RESULTS
  LVD was present in 59.9% of patients. Age (OR 1.05, 95% CI [1.02-1.07]), HbA1c (OR 1.27, 95% CI [1.09-1.49]), triglycerides (OR 1.003, 95% CI [1.001-1.006]), treatment with metformin (OR 1.62, 95% CI [1.09-2.40]) and doxazosine (OR 2.48, 95% CI [1.10-5.55]) were independent predictors of LVD. Glitazones were associated with reduced risk of diastolic dysfunction (OR 0.44, 95% CI [0.22-0.87]) whereas waist circumference and metformin were adversely associated with systolic dysfunction (OR 1.02, 95% CI [1.01-1.04] and 1.57, 95% CI [1.01-2.43], respectively).
  
  
  CONCLUSIONS
  In asymptomatic and fairly controlled diabetic patients, age, worse HbA1c, traits of insulin resistance, such as visceral adiposity and triglycerides or treatment with metformin, and use of doxazosin indicate greater risk of LVD. Glitazones, at this stage, seem to be associated with better diastolic performance.
authors: Diabetes and Metabolism Unit, ASL Torino 5, Chieri, Italy.
authors: Carlo B
authors: CB
authors: Giorda
authors: Giovanni
authors: G
authors: Cioffi
authors: Giovanni
authors: G
authors: de Simone
authors: Andrea
authors: A
authors: Di Lenarda
authors: Pompilio
authors: P
authors: Faggiano
authors: Roberto
authors: R
authors: Latini
authors: Donata
authors: D
authors: Lucci
authors: Aldo P
authors: AP
authors: Maggioni
authors: Luigi
authors: L
authors: Tarantini
authors: Mario
authors: M
authors: Velussi
authors: Paolo
authors: P
authors: Verdecchia
authors: Marco
authors: M
authors: Comaschi
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D006442:Glycated Hemoglobin