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www.e-kdj.orgCopyright © 2010 Korean Diabetes Association
Risk Factors Associated with Left Ventricular Diastolic
Dysfunction in Type 2 Diabetic Patients without
Jung Hyun Noh1,2, Joon Hyung Doh1, Sung Yun Lee1, Tae Nyun Kim3, Hyuk Lee1, Hwa Young Song1, Jeong Hyun Park1,
Kyung Soo Ko1, Byoung Doo Rhee1, Dong Jun Kim1
1Department of Internal Medicine, Inje University College of Medicine, Goyang,
2Clinical Research Center, Inje University Ilsan Paik Hospital, Goyang,
3Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
Background: Hypertension and age are recognized as important risk factors for left ventricular (LV) diastolic dysfunction. Some
studies have shown that diabetes itself may also be an independent risk factor for LV diastolic dysfunction, although this is con-
troversial. The aim of this study was to determine the factors associated with LV diastolic dysfunction in patients with type 2 dia-
betes in the absence of hypertension or ischemic heart disease (IHD).
Methods: Participants in this study consisted of 65 type 2 diabetes patients (M : F = 45 : 20; mean age 51 [26 to 76] years; mean
body mass index [BMI] 25.0 ± 2.5 kg/m2) without hypertension, heart disease, or renal disease. Individuals with ischemic elec-
trocardiographic changes were excluded. LV diastolic function was evaluated by Doppler echocardiographic studies.
Results: Fifteen patients (23.1%) showed LV diastolic dysfunction on Doppler echocardiographic studies. Patients with LV dia-
stolic dysfunction were older than those without diastolic dysfunction (60.0 ± 2.5 vs. 50.5 ± 1.9 years; P < 0.01). After adjusting
for age and sex, BMI was higher (26.6 ± 0.7 vs. 24.6 ± 0.3 kg/m2; P < 0.01) and diabetes duration was longer (9.65 ± 1.48 vs. 4.71
± 0.78 years; P < 0.01) in patients with LV diastolic dysfunction than in those without diastolic dysfunction. There were no differ-
ences in sex, smoking, blood pressure, lipid profiles, hemoglobin A1C, fasting glucose, fasting insulin, or diabetic microvascular
complications between the LV diastolic dysfunction group and the normal diastolic function group. After adjusting for age, sex,
and BMI, diabetes duration was found to be independently associated with LV diastolic dysfunction (odds ratio 1.38; confidence
interval 1.12 to 1.72; P = 0.003).
Conclusion: These results suggest that diabetes duration may be a risk factor for LV diastolic dysfunction in type 2 diabetic pa-
tients without hypertension or IHD.
Keywords: Diabetes duration; Diabetes mellitus; Left ventricular diastolic dysfunction
Corresponding author: Dong Jun Kim
Department of Internal Medicine, Inje University Ilsan Paik Hospital,
2240 Daehwa-dong, IlsanSeo-gu, Goyang, Gyeonggi 411-706, Korea
Received: May 25, 2009; Accepted: Jan. 15, 2010
Heart failure is a common comorbidity and fatal complication
of diabetes mellitus. The Framingham heart study demonstrat-
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two-fold higher incidence in men and a five-fold higher inci-
dence in women with diabetes compared with age-matched
non-diabetic subjects . Many epidemiological studies have
confirmed a significantly increased prevalence of cardiac dys-
function in diabetic patients, independent of the influence of
relevant covariates [2-4]. Left ventricular (LV) diastolic dys-
function is thought be an early preclinical manifestation of
Korean Diabetes J 2010;34:40-46
pISSN 1976-9180 · eISSN 2093-2650
Noh JH, et al.
Korean Diabetes J 2010;34:40-46www.e-kdj.org
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