Female is Associated with Left Ventricular Diastolic Dysfunction in Patients with Type 2 Diabetes

Figures & data

Figure 1 Flowchart of study participants.

Abbreviation: MMC, Metabolic Management Center.

Table 1 Baseline Characteristics

Parameters	Total (1778)	Male (1205)	Female (573)	p
Age (years)	50.0±10.89	49.2±10.74	51.7 ±10.99	0.000
Diastolic pressure (mmHg)	73±8.5	74±8.7	72±8.2	0.000
Systolic pressure (mmHg)	116±12.6	116±12.4	117±12.9	0.431
Body mass index (kg/m^2)	24.51±3.441	24.68±3.339	24.17±3.623	0.003
Visceral fat area (cm^2)	85.14±39.867 (n=1672)	87.34±41.531 (n=1143)	80.36±35.582 (n=529)	0.000
Subcutaneous fat area (cm^2)	173.10±62.514 (n=1658)	173.24±61.22 (n=1134)	172.79±65.286 (n=524)	0.894
Family history of diabetes	549(30.9)	354(29.4)	195(34.0)	0.047
Diabetic duration (months)	87.7±72.2 (n=1369)	86.7±70.4 (n=905)	89.7±75.7 (n=464)	0.465
HbA1c (%)	10.0±2.68	10.1±2.69	9.8±2.65	0.012
Serum glucose (mmol/L)	8.6±3.680	8.7±3.77	8.5±3.49	0.461
ALT (U/L)	21(15,32)	22(16,33)	18(13,28)	0.000
AST (U/L)	18(15,24)	18(15,24)	18(14,23)	0.116
Serum albumin (g/L)	40±4.33	40±4.4	39±4.0	0.000
Blood urea nitrogen (mmol/L)	5.41±2.44	5.6±2.73	5.1±1.61	0.000
Serum creatinine (umol/L)	64±15.8	70±14.4	53±11.4	0.000
Uric acid (umol/L)	355±95.3	371±93.9	321±89.3	0.000
Triglyceride (mmol/L)	1.70(1.12,2.74)	1.75(1.13,2.87)	1.62(1.06,2.52)	0.010
Total cholesterol (mmol/L)	4.8±1.30	4.8±1.32	4.9±1.25	0.031
HDL cholesterol (mmol/L)	1.0±0.28	1.0±0.28	1.1±0.25	0.000
LDL cholesterol (mmol/L)	2.8±0.90	2.8±0.87	2.9±0.96	0.019
ACR (mg/g)	12(2.7,69.4)	11(2.7, 64.4)	13(2.6,76.3)	0.551
Smoke	726(40.8)	709(58.8)	17(3.0)	0.000
Drink	673(55.9)	621(51.5)	52(9.1)	0.000
Left atrium diameter (mm)	33.27±5.348	33.74±5.246	32.28±5.430	0.000
Interventricular septum thickness (mm)	10.22±3.270	10.47±3.625	9.67±2.254	0.000
Left ventricular end-diastolic diameter (mm)	43.45±7.023	44.36±6.960	41.54±6.773	0.000
Left ventricular end-systolic diameter (mm)	27.52±4.93	28.25±4.729	26.00±4.995	0.000
Left ventricular posterior wall thickness (mm)	9.49±3.046	9.61±2.343	9.26±4.154	0.060
Aortic root inner diameter (mm)	24.41±4.658	25.32±4.851	22.59±3.733	0.000
Ejection fraction (%)	67.41±6.103	67.5±6.096	68.17±6.055	0.000
Left ventricular diastolic function	877(49.3)	565(46.9)	312(54.5)	0.003

Note: Data presented as mean ± SD or median (range).

Abbreviations: ALT, alanine aminotransferase; AST, aspartate transaminase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; ACR, albumin-to-creatinine ratio.

Table 2 Univariate Logistic Regression

Parameters	HR	95%	P value
Female	1.354	1.109–1.653	0.003
Age (years)	1.128	1.114–1.143	0.000
Diastolic pressure (mmHg)	1.022	1.011–1.033	0.000
Systolic pressure (mmHg)	1.024	1.017–1.032	0.000
Body mass index (kg/m^2)	1.019	0.992–1.047	0.177
Visceral fat area (cm^2)	1.004	1.002–1.007	0.001
Subcutaneous fat area (cm^2)	1.002	1.001–1.004	0.002
Family history of diabetes	1.430	1.168–1.752	0.001
Diabetic duration (months)	1.005	1.004–1.007	0.000
HbA1c (%)	0.891	0.859–0.923	0.000
Serum glucose (mmol/L)	0.992	0.967–1.017	0.522
ALT (U/L)	0.995	0.991–0.0999	0.024
AST (U/L)	0.997	0.990–1.004	0.405
Serum albumin (g/L)	1.006	0.984–1.027	0.615
Blood urea nitrogen (mmol/L)	1.151	1.085–1.221	0.000
Serum creatinine (umol/L)	1.012	1.006–1.018	0.000
Uric acid (umol/L)	1.001	1.000–1.002	0.253
Triglyceride (mmol/L)	1.004	0.975–1.033	0.811
Total cholesterol (mmol/L)	1.001	0.932–1.076	0.973
HDL cholesterol (mmol/L)	1.337	0.950–1.881	0.096
LDL cholesterol (mmol/L)	0.993	0.896–1.101	0.893
ACR (mg/g)	1.000	1.000–1.000	0.432
Smoke	0.885	0.732–1.070	0.206
Drink	0.963	0.795–1.166	0.699
Left atrium diameter (mm)	1.049	1.029–1.070	0.000
Interventricular septum thickness (mm)	1.024	0.990–1.059	0.170
Left ventricular end-diastolic diameter (mm)	0.988	0.975–1.002	0.082
Left ventricular end-systolic diameter (mm)	0.984	0.965–1.003	0.099
Left ventricular posterior wall thickness (mm)	1.076	1.029–1.124	0.001
Aortic root inner diameter (mm)	1.018	0.997–1.039	0.088
Ejection fraction (%)	0.994	0.979–1.009	0.452

Abbreviations: ALT, alanine aminotransferase; AST, aspartate transaminase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; ACR, albumin-to-creatinine ratio.

Table 3 Multivariate Logistic Regression

Parameters	HR	95%	P value
Female	1.548	1.014–2.363	0.043
Age (years)	1.147	1.125–1.170	0.000
Diastolic pressure (mmHg)	1.030	1.008–1.052	0.006
Systolic pressure (mmHg)	0.994	0.980–1.009	0.448
Body mass index (kg/m^2)	1.074	0.992–1.163	0.076
Visceral fat area (cm^2)	0.996	0.992–1.001	0.141
Subcutaneous fat area (cm^2)	1.004	1.000–1.008	0.049
Diabetic duration (months)	1.000	0.998–1.003	0.628
HbA1c (%)	0.979	0.923–1.039	0.485
Family history of diabetes	1.327	0.991–1.779	0.058
Smoke	1.147	0.819–1.606	0.425
Drink	0.996	0.730–1.359	0.978
Serum albumin (g/L)	1.037	1.000–1.076	0.052
ALT (U/L)	1.002	0.989–1.015	0.790
AST (U/L)	0.998	0.978–1.018	0.823
Blood urea nitrogen (mmol/L)	1.021	0.958–1.088	0.530
Serum creatinine (umol/L)	1.006	0.994–1.017	0.332
ACR (mg/g)	1.000	1.000–1.000	0.632
Uric acid (umol/L)	1.001	0.999–1.002	0.461
Triglyceride (mmol/L)	1.080	0.970–1.203	0.160
Total cholesterol (mmol/L)	0.880	0.653–1.185	0.399
HDL-cholesterol (mmol/L)	0.836	0.408–1.714	0.625
LDL cholesterol (mmol/L)	1.157	0.828–1.617	0.394

Abbreviations: ALT, alanine aminotransferase; AST, aspartate transaminase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; ACR, albumin-to-creatinine ratio.

Figure 2 The association between clinical factors and left ventricular diastolic dysfunction determined by multivariate logistic analysis.

Abbreviations: ALT, alanine aminotransferase; AST, aspartate transaminase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; ACR, albumin-to-creatinine ratio; HR, hazard ratio; CI, confidence interval.

Figure 3 The sex difference of left ventricular diastolic dysfunction in different age groups.

Note: *P < 0.05.

Abbreviation: ns, not statistically significant.