title: Association of myocardial dysfunction with vitamin D deficiency in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  The underlying mechanism of myocardial dysfunction in patients with type 2 diabetes mellitus (T2DM) is unclear. Nonetheless recent studies have revealed that vitamin D (vit-D) deficiency, which is prevalent in such patients, is associated with adverse cardiovascular events. We hypothesized that vit-D deficiency in patients with T2DM may contribute to left ventricular (LV) dysfunction.
  
  
  METHODS
  We studied 95 patients (62±9years, 58% female) with T2DM. None had any history of coronary artery disease and all underwent detailed transthoracic echocardiography, including speckle tracking derived strains. Plasma level of 25-hydoxyvitamin D (25-OHD) was also measured.
  
  
  RESULTS
  Vitamin D deficiency was evident in 60 (63%) patients. The LV dimension, LVEF and diastolic grade were similar between those with and without deficiency although an impaired global longitudinal strain was present in the former. Importantly, 25-OHD was negatively associated with global longitudinal strain (R = -0.21, P=0.046) and positively with body-mass index (BMI; R=0.26, P=0.01). Both vit-D deficiency and BMI were associated with impaired global LV longitudinal strain, independent of T2DM disease characteristics.
  
  
  CONCLUSIONS
  In patients with T2DM and no history of coronary artery disease, vit-D deficiency is independently associated with impaired global longitudinal strain. This suggests that vit-D deficiency may contribute to the development of myocardial dysfunction in these patients.
authors.affiliation: Division of Cardiology, Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Chun-Ting
authors.initials: CT
authors.lastname: Zhao
authors.affiliation: Division of Cardiology, Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zhen
authors.affiliation: Division of Cardiology, Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Arthur
authors.initials: A
authors.lastname: Wong
authors.affiliation: Division of Cardiology, Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, China. Electronic address: hftse@hkucc.hku.hk.
authors.forename: Hung Fat
authors.initials: HF
authors.lastname: Tse
authors.affiliation: Division of Cardiology, Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, China. Electronic address: khkyiu@hku.hk.
authors.forename: Kai Hang
authors.initials: KH
authors.lastname: Yiu
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006331:Heart Diseases / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000503:physiopathology*
chemical_list: D001786:Blood Glucose; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Diabetes Mellitus; Myocardial dysfunction; Vitamin D deficiency