Sudomotor dysfunction is associated with impaired left ventricular diastolic function in persons with type 2 diabetes: a cross-sectional study,Journal of Endocrinological Investigation

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Sudomotor dysfunction is associated with impaired left ventricular diastolic function in persons with type 2 diabetes: a cross-sectional study
Journal of Endocrinological Investigation ( IF 3.9 ) Pub Date : 2023-11-24 , DOI: 10.1007/s40618-023-02214-0
X Chen ₁ , X Shui ₂ , H Xu ₁ , J Peng ₁ , H Deng ₁ , J Zhong ₃ , C Wang ₁ , J Wu ₁ , J Yan ₁ , B Yao ₁ , Z Xiong ₂ , W Xu ₁ , X Yang ₁

Affiliation

Background

The incidence of preserved ejection fraction heart failure has significantly increased in persons with type 2 diabetes mellitus (T2DM). Left ventricular (LV) diastolic dysfunction is an early and important manifestation of preserved ejection fraction heart failure. The onset of heart failure in persons with diabetes is associated with diabetic neuropathy. However, the relationship among sudomotor function, which is an early manifestation of small fiber neuropathy, and LV diastolic function remains unclear. This study aimed to explore the association between sudomotor function and LV diastolic function in persons with T2DM.

Methods

In total, 699 persons with T2DM were enrolled and divided into three groups according to electrochemical skin conductance (ESC) assessed using the SUDOSCAN device: “no dysfunction” group (NSF), “moderate dysfunction” group (MDF), and “severe dysfunction” group (SDF). LV diastolic function was assessed using Doppler echocardiography. To evaluate the relationship between ESC and echocardiographic parameters, Pearson’s correlation analysis was performed. Additionally, logistic regression analysis was used to determine the association between LV diastolic function and ESC. A receiver operating characteristic (ROC) curve was constructed to evaluate the performance of sudomotor function indicators in detecting impaired cardiac diastolic function.

Results

There were 301 persons (43.06%) in the NSF group, 232 (33.19%) in the MDF group, and 166 (23.75%) in the SDF group. Compared to the NSF group, the MDF and SDF groups had higher A and E/e′ and lower e′ values (all p < 0.05). Pearson’s correlation analysis showed that A and E/e′ were negatively associated with foot ESC (FESC) and hand ESC (HESC), whereas e′ was positively associated with FESC and HESC (all p < 0.05). After adjusting for confounding factors, binary logistic regression analysis showed that ESC was independently associated with impaired LV diastolic function (p = 0.003). The area under the ROC curve values for FESC and HESC were 0.621 and 0.635, respectively (both p < 0.05).

Conclusions

Deteriorating sudomotor function was associated with reduced diastolic function indicators. ESC can be used as a biomarker for detecting LV diastolic impairment.

中文翻译：

排汗功能障碍与 2 型糖尿病患者左心室舒张功能受损相关：一项横断面研究

背景

2 型糖尿病 (T2DM) 患者射血分数保留性心力衰竭的发生率显着增加。左心室（LV）舒张功能障碍是射血分数保留性心力衰竭的早期重要表现。糖尿病患者心力衰竭的发作与糖尿病性神经病变有关。然而，促汗功能（小纤维神经病的早期表现）与左室舒张功能之间的关系仍不清楚。本研究旨在探讨 T2DM 患者促汗功能与左室舒张功能之间的关联。

方法

总共招募了 699 名 T2DM 患者，并根据使用 SUDOSCAN 设备评估的电化学皮肤电导（ESC）分为三组：“无功能障碍”组（NSF）、“中度功能障碍”组（MDF）和“严重功能障碍”组”小组（自卫队）。使用多普勒超声心动图评估左室舒张功能。为了评估 ESC 和超声心动图参数之间的关系，进行了 Pearson 相关分析。此外，还使用逻辑回归分析来确定 LV 舒张功能与 ESC 之间的关联。构建受试者工作特征（ROC）曲线来评估促汗功能指标在检测心脏舒张功能受损方面的表现。

结果

NSF组301人（43.06%），MDF组232人（33.19%），SDF组166人（23.75%）。与 NSF 组相比，MDF 和 SDF 组的A和E / e ' 较高， e ' 值较低（均p < 0.05）。 Pearson 相关分析显示， A和E / e ' 与足 ESC (FESC) 和手 ESC (HESC) 呈负相关，而e ' 与 FESC 和 HESC 呈正相关（均p < 0.05）。调整混杂因素后，二元逻辑回归分析显示 ESC 与左心室舒张功能受损独立相关 ( p = 0.003)。 FESC 和 HESC 的 ROC 曲线下面积值分别为 0.621 和 0.635（均p < 0.05）。