Effect of glycemic control on progress of left ventricular structure and diastolic dysfunction in adolescent with type 1 diabetes mellitus
10.3760/cma.j.issn.2095-428X.2013.13.007
- VernacularTitle:血糖控制对青少年1型糖尿病左心室结构和功能的影响
- Author:
Ni LIAO
1
;
Song FU
;
Xian-Min WANG
;
Qin ZHOU
;
Zi-Hong XIONG
;
Yong-Hong GUO
;
Guo-Ying ZHANG
Author Information
1. 610000,成都市妇女儿童中心医院儿童重症医学科
- Keywords:
Glycemic control;
Type 1 diabetes mellitus;
Left ventricular structure;
Left ventricular function;
Adolescent
- From:
Chinese Journal of Applied Clinical Pediatrics
2013;28(13):980-982
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of glycemic control on progress of left ventricular structure and diastolic dysfunction in adolescents with type 1 diabetes mellitus (T1 DM).Methods A total of 36 T1DM adolescent patients(observation group) and 36 age-matched healthy controls (healthy control group),who consulted doctors in Chengdu Women and Children's Central Hospital between Dec.2009 and Dec.2010,were recruited into the study.Patients in the observation group were performed standard treatment for glycemic control.All patients were followed-up for 2 years.At the end of the study,the patients in observation group were divided into 3 subgroups according to the average HbA1 c level:excellent glycemic control group [glycosylated hemoglobin (HbA1 c) ＜ 7.6％],good glycemic control group(7.6％ ≤HbA1c≤9.0％) and bad glycemic control group(HbA1c ＞9.0％).All of the subjects were evaluated by means of echocardiography for assessment of left ventricular structural and functional parameters.Results Left ventricular posterior wall depth (LVPW),left ventricular mass index (LVMI) and isovolumic relaxation time (IVRT) were elevated,while E/A was decreased in the observation group compared with the healthy control group at baseline (all P ＜ 0.05).There was no significant difference between 2 groups in interventricular septum thickness (IVS),left ventricular end-diastolic dimension(LVEDd) and cardiac systolic function(all P ＞ 0.05).Echocardiographic parameters of left ventricular structure and function were unchanged in well-controlled patients.At the end of follow-up,mild-control group and non-control group demonstrated increased IVS,LVPW and LVMI,and exacerbated left ventricular diastolic function in the present of IVRT prolonging and E/A decreasing.Conclusions There is an inclination in T1 DM adolescent patients developing to left ventricular diastolic dysfunction,and improved glycemic control can delay the progress of left ventricnlar hypertrophy,but it can't ameliorate the decreased diastolic dysfunction.Whereas,non-improved glycemic control can accelerate left ventricular remodeling and exacerbate diastolic dysfunction in T1DM adolescent patients.
