Duration Of Diabetes Were Significantly Associated With The Cardiac Structure And Function In The Elderly Patients With Type 2 Diabetes

Objective Analyze the influences of diabetes duration on cardiac structure and function in the elderly patients with type 2 diabetes(T2DM).Methods Collected 714 patients with T2DM aged 60 years or older who were hospitalized in our department of Geriatrics from January 2015 to December 2017.According to the differentce of diabetes duration,they were divided into 4 groups(1-5 years,6-10 years,11-15 years and>15 years).To analyze the correlation between diabetes duration and the risk of coronary heart disease.Comparing the differences of cardiac ultrasound parameters among different groups.Results The prevalence of coronary heart disease increased with the increasing of the diabetes duration in the elderly patients with T2DM(respectively was 24.5%,38%,47.3%,56.8%in 1-5 years group,6-10 years group,11-15 years group and>15 years group).The risk of coronary heart disease also significantly increased with the increasing of diabetes duration.After adjusting for age,smoking,hypertension,abdominal circumference(AC),BMI,FPG,HbA1c,blood lipids,history of drug application and other factors,the OR value(95%CI)of the coronary heart disease,risk respectively was 2.24(1.30-3.86),3.24(1.66-6.34),5.84(2.65-12.87)in 6-10 years group,11-15 years group and>15 years group compared with the 1-5 years group(OR = 1.0).With the increasing of the diabetes duration,the diastolic left ventricular posterior wall thickness and left ventricular mass gradually increased in elderly patients with type 2 diabetes,respectively[(0,89±10.01,0.92±0.01,0.94±0.01,0.99±0.01)cm;(168.12±3.13,173.21±3.36,184.03±4.34,200.45±3.26)g](trend P<0.05).The difference was still statistically significant after adjusting for age,smoking,hypertension,AC,BMI,FPG,HbAlc,blood lipids,history of drug application and other factors(trend P<0.05).Spearman correlation analysis showed that the risk of diastolic dysfunction(E/A<1)was positively correlated with age,duration of diabetes,HbAlc,FPG,and LDL(r,P respectively was 0.16,0.012;0.29,<0.001;0.14,0.036;0.13,0.039;0.18,0.004),was negatively correlated with HDL(r=-0.19,P<0.001),and there was no significant correlation with AC,BMI,TG,TC(P>0.05).The risk of E/A<1 was gradually increased with the increasing of the diabetes duration.After adjusting for smoking,hypertension,coronary heart disease,AC,BMI,FPG,HbAlc,blood lipids,history of drug application and other factors,the OR value(95%CI)of the diastolic dysfunction(E/A<1)risk respectively was 1.23(0.75-2.03),2.28(1.18-4.39),2.74(1.24-6.05)in 6-10 years group,11-15 years group and>15 years group compared with the 1-5 years group(OR=1.0).Conclusions With the increase of diabetes duration,the diastolic left ventricular posterior wall thickness and left ventricular mass increased gradually,and the risk of diastolic dysfunction increased gradually in elderly patients with T2DM.