Change of Cardiac Function and NT-proBNP According to Degree of Albuminuria in Type 2 Diabetic Patients

Ku, Bon Jeong; Kim, Jeong Hee; Jeong, Jin Ok; Jeon, Eun Seok; Seo, Dong Hyun; Lee, Jae Min; Choi, Si Wan; Seong, In Whan; Kim, Young Kun

Abstract

BACKGROUND: The prevalence of diabetes mellitus has increased recently. The morbidity and mortality of diabetic patients are mainly caused by chronic complications, especially cardiovascular events. N-terminal proB-type natriuretic peptide(NT-proBNP) is a neurohormone that is secreted from ventricular myocardium due to myocardial dilatation or pressure overload. NT-proBNP has prognostic value, and reflects cardiac function in patients with myocardial infarction or heart failure. This study was performed to evaluate functional changes of the heart, according to the degree of albuminuria and the prognostic value of NT-proBNP in type 2 diabetic patients.
METHODS
57 patients with type 2 diabetes were divided into three groups according to their degree of albuminuria, these being normal(below 30mg/day), microalbuminuria(30 between 300mg/day) and overt proteinuria(over 300mg/ day). The clinical parameters in each of the patients were evaluated, echocardiography performed and the levels of NT-proBNP checked, and compared between the three groups.
RESULTS
Of the 57 patients with type 2 diabetes the male:female ratio of 32:25, with mean age, duration of diabetes and BMI of 55.8+/-10.1 and 11.3+/-8.2 years, and 23.2+/-4.0kg/m2, respectively. Twenty-eight patients showed normal(49.1%), 15 microalbuminuria(26.3%) and 14 overt proteinuria(24.6%). The age, BMI, diastolic BP and glycosylated hemoglobin showed no significant difference between the three groups. The duration of diagnosed diabetes was significantly longer, the systolic blood pressure and serum creatinine levels significantly higher and the serum hemoglobin significantly lower (p<0.05) in the overt proteinuria compared to the normal group. The duration of diabetes was significantly longer and serum creatinine levels significantly higher in the overt proteinuria than the microalbuminuria group(p<0.05). The echocardiographic data showed no difference among the groups. The NT-proBNP levels also showed no significant difference, but tended to be elevated toward albuminuria.
CONCLUSION
The cardiac function and NT-proBNP levels showed no significant difference between each of the albuminuric groups. This study suggests that the degree of albuminuria is not a predictive factor for changes of the cardiac function and NT-proBNP levels