Objective To explore the diagnostic and prognostic value of insulin growth factor 1 receptor(IGF1R)as a biomarker for the progression of heart failure with preserved ejection fraction(HFpEF)in patients with type 2diabetes mellitus(T2DM).Methods A total of 383 patients with type 2diabetes who received treatment in the hospital from June 2019 to March 2023 were selected as the study objects,and they were divided into non-HFPEF group(n=190)and HFpEF group(n=193)according to diagnostic criteria of HF-pEF.The clinical data of the patients were collected,and the IGF1R level was determined by enzyme-linked immunosorbent assay(ELISA).Paired sample t-test,nonparametric test or x2 test were used to compare clinical data and echocardiographic results.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of IGF1R in HFpEF.Nonparametric test was used to com-pared baseline and post-follow-up echocardiography;Kaplan-Meier curves were used to assess the effects of IGF1R levels on readmis-sion.Results Analysis by whether to merge HFpEF groups showed that,in HFpEF group,the patients were older,the proportion of atri-al fibrillation patients was higher,the duration of diabetes was longer(P＜0.05),the levels of blood glucose,creatinine,N-terminal pro-brain natriuretic peptide(NT-proBNP)and IGF1R were significantly increased(P＜0.05),and echocardiography also showed that the systolic and diastolic function of the heart was significantly decreased(P＜0.05).Similar results were obtained by IGF1R hori-zontal grouping.The ROC curve showed that the area under the curve(AUC)of IGF1R for predicting HFpEF in T2DM patients was 0.79.Subgroup analysis of non-HFPEF and HFpEF groups based on IGF1R levels showed that patients with high IGF1R in both the non-HFPEF and HFpEF groups had worse systolic and diastolic function(P＜0.05).Follow-up revealed that the systolic and diastolic function in the high IGF1R group decreased significantly from baseline(P＜0.05).Kaplan-Meier curve analysis showed a significantly increased risk of re-hospitalization due to cardiovascular events in the high IGF1R group(P=0.007).Conclusion IGF1R can be used as a biomarker to monitor structural and functional damage of heart,diagnosing the risk of HFpEF,and predicting the long-term de-terioration of cardiac structure and function in T2DM patients.

Objective To explore the diagnostic and prognostic value of insulin growth factor 1 receptor(IGF1R)as a biomarker for the progression of heart failure with preserved ejection fraction(HFpEF)in patients with type 2diabetes mellitus(T2DM).Methods A total of 383 patients with type 2diabetes who received treatment in the hospital from June 2019 to March 2023 were selected as the study objects,and they were divided into non-HFPEF group(n=190)and HFpEF group(n=193)according to diagnostic criteria of HF-pEF.The clinical data of the patients were collected,and the IGF1R level was determined by enzyme-linked immunosorbent assay(ELISA).Paired sample t-test,nonparametric test or x2 test were used to compare clinical data and echocardiographic results.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of IGF1R in HFpEF.Nonparametric test was used to com-pared baseline and post-follow-up echocardiography;Kaplan-Meier curves were used to assess the effects of IGF1R levels on readmis-sion.Results Analysis by whether to merge HFpEF groups showed that,in HFpEF group,the patients were older,the proportion of atri-al fibrillation patients was higher,the duration of diabetes was longer(P＜0.05),the levels of blood glucose,creatinine,N-terminal pro-brain natriuretic peptide(NT-proBNP)and IGF1R were significantly increased(P＜0.05),and echocardiography also showed that the systolic and diastolic function of the heart was significantly decreased(P＜0.05).Similar results were obtained by IGF1R hori-zontal grouping.The ROC curve showed that the area under the curve(AUC)of IGF1R for predicting HFpEF in T2DM patients was 0.79.Subgroup analysis of non-HFPEF and HFpEF groups based on IGF1R levels showed that patients with high IGF1R in both the non-HFPEF and HFpEF groups had worse systolic and diastolic function(P＜0.05).Follow-up revealed that the systolic and diastolic function in the high IGF1R group decreased significantly from baseline(P＜0.05).Kaplan-Meier curve analysis showed a significantly increased risk of re-hospitalization due to cardiovascular events in the high IGF1R group(P=0.007).Conclusion IGF1R can be used as a biomarker to monitor structural and functional damage of heart,diagnosing the risk of HFpEF,and predicting the long-term de-terioration of cardiac structure and function in T2DM patients.