New insights into the mechanisms of diastolic dysfunction in patients with type 2 diabetes

Figures & data

Figure 1. Comparison of serum sRAGE levels according to the presence of diastolic dysfunction in diabetic patients.

Table I. Clinical and laboratory characteristics of study subjects (n = 80).

	Healthy control (n = 40)	Diabetic patient (n = 40)	p
Parameters
Age, years	41.1 ± 8.5	43.2 ± 7.9	0.233
Female gender	24 (60%)	21 (52.5%)	0.499
BMI, kg/m^2	27.2 ± 3.2	30.4 ± 4.7	0.001*
Waist–hip ratio, cm	0.88 ± 0.06	0.92 ± 0.04	0.002*
SBP, mmHg	120 (100–140)	125 (100–140)	0.878
DBP, mmHg	75 (60–85)	75 (60–85)	0.728
Duration of diabetes, years	NA	2 (0.5–9)
Fasting blood glucose, mmol/l	4.75 ± 0.45	8.16 ± 2.96	0.001*
HbA1c, %	5.0 ± 0.6	7.1 ± 1.6	0.001*
Total cholesterol, mmol/l	5.20 ± 0.83	4.85 ± 0.94	0.079
TG, mmol/l	1.37 (0.44–4.46)	1.45 (0.45–3.73)	0.977
LDL cholesterol, mmol/l	3.2 ± 0.8	3.0 ± 0.9	0.232
HDL cholesterol, mmol/l	1.28 ± 0.38	1.28 ± 0.35	0.957
Serum creatinine, μmol/l	70.7 (46.0–102.5)	69.8 (42.4–96.4)	0.567
Uric acid, μmol/l	280 ± 65	294 ± 77	0.365
ALT, U/L	15 (7–45)	16 (6–48)	0.311
AST, U/L	18 (10–44)	20 (10–38)	0.201
sRAGE, pg/ml	1044 ± 344	676 ± 128	0.001*
Diastolic dysfunction	0	20 (50%)	0.001*
Grade 1	0	16 (40%)
Grade 2	0	4 (10%)
E/A	1.3 ± 0.3	1.0 ± 0.3	0.001*
E/E’ (Average)	6.4 ± 0.9	7.4 ± 1.0	0.001*

BMI, Body mass index; SBP, Systolic blood pressure; DBP, Diastolic blood pressure; HBA1c, Glycated hemoglobin; TG, Triglyceride; LDL, Low-density lipoprotein; HDL, High-density lipoprotein; ALT, Alanine transaminase; AST, Aspartate transaminase; sRAGE, Serum soluble advanced glycation end products.

*p < 0.05.

Figure 2. The relationship between sRAGE levels and the duration of diabetes.

Table II. Simple correlation analysis of variables associated with serum sRAGE levels.

	r	p
Clinical and laboratory parameters
Age, years	− 0.092	0.578
Female gender	− 0.048	0.770
BMI, kg/m^2	0.102	0.533
Waist–hip ratio	0.166	0.305
SBP, mmHg	0.198	0.221
DBP, mmHg	0.048	0.767
Duration of diabetes, years	− 0.323	0.042*
Fasting blood glucose, mmol/l	0.126	0.438
HbA1c, %	0.239	0.138
Total cholesterol, mmol/l	− 0.054	0.742
TG, mmol/l	− 0.340	0.032*
HDL cholesterol, mmol/l	0.208	0.197
LDL cholesterol, mmol/l	− 0.134	0.411
Uric acid, μmol/l	− 0.220	0.172
Echocardiographic parameters
Mitral peak E velocity, cm/s	0.051	0.755
Mitral peak A velocity, cm/s	− 0.090	0.579
Mitral peak E/A ratio	0.107	0.509
DT, ms	− 0.105	0.519
IVRT, ms	− 0.14	0.933
Lateral E’, cm/s	0.442	0.004*
Lateral A’, cm/s	0.032	0.845
Lateral E’/A’	0.315	0.047*
Septal E’, cm/s	0.341	0.031*
Septal A’, cm/s	− 0.162	0.317
Septal E’/A’	0.406	0.009*
E/E’ (Lateral)	− 0.399	0.011*
E/E’ (Septal)	− 0.315	0.048*
E’ (average), cm/s	0.252	0.116
E/E’ (average)	− 0.465	0.003*

BMI, Body mass ındex; DBP, Dıastolıc blood pressure; HBA1C, Glycated hemoglobin; HDL, Hıgh-densıty lıpoproteın; IVRT, Isovolumıc relaxatıon tıme; LDL, Low-densıty lıpoproteın; SBP, Systolıc blood pressure; SRAGE, Soluble advanced glycatıon end products; TG, Trıglycerıde.

*p < 0.05.

Figure 3. The relation between duration of diabetes and LV diastolic dysfunction.

Figure 4. The relationship between sRAGE levels and grades of diastolic dysfunction.