Cardiovasc Diabetol: a new inflammatory marker and lipoprotein associated with subclinical myocardial dysfunction in patients with T1DM

The incidence of heart failure (HF) is increased in patients with type 1 diabetes mellitus (T1DM), and its occurrence is related
to multiple pathophysiology.
The purpose of the study was to analyze the potential contribution
of advanced lipoprotein profiling and plasma glycosylation (GlycA) to subclinical myocardial dysfunction in patients with T1DM.

Patients with T1DM with diastolic and/or systolic subclinical myocardial dysfunction from the Danish T1DM patient cohort were included, and control individuals
without myocardial dysfunction matched for age, sex and HbA1c were included.
All subjects underwent transthoracic echocardiography and obtained advanced lipoprotein profiles
with an MRI-based Liposcale® test.
In addition, the researchers analyzed the GlycA NMR signal
.
Systolic dysfunction is defined as left ventricular ejection fraction ≤45%, and diastolic dysfunction is defined as E/e′≥12 or E/e=′8-12 + left atrial volume >34 ml/m2
.
To determine the metabolic profile associated with the presence of subclinical myocardial dysfunction, the researchers employed a multivariate supervised classification model
based on least squares regression (PLS-DA regression).

A total of 146 patients with diastolic dysfunction and 18 patients with systolic dysfunction were included
.
Compared with the control group, patients with myocardial dysfunction had a longer duration of diabetes (p=0.
005), a higher BMI index (p=0.
013), a higher serum NT-proBNP level (p=0.
001), a higher systolic blood pressure (p<0.
001), and a higher incidence of proteinuria and advanced retinopathy (p<0.
001).

ROC curve of PLS-DA classification model

The supervised classification model identifies a specific pattern associated with myocardial dysfunction, with the ability to
distinguish patients with myocardial dysfunction from a control group.
PLS-DA showed that triglyceride-rich lipoproteins (TGRL), such as VLDL (total VLDL granules, large VLDL subclasses, and VLDL-TG content) and IDL (IDL cholesterol content), as well as plasma GlycA concentrations, were associated
with the presence of subclinical myocardial dysfunction.

In summary, atherogenic TGRL and pro-inflammatory biomarker Glyc A were strongly associated
with myocardial dysfunction in patients with T1DM.
The results suggest that TGRL and systemic inflammation play a key role
in the development of T1DM subclinical myocardial dysfunction.

Original source:

Puig-Jové, C.
, Julve, J.
, Castelblanco, E.
et al.
The novel inflammatory biomarker GlycA and triglyceride-rich lipoproteins are associated with the presence of subclinical myocardial dysfunction in subjects with type 1 diabetes mellitus.
Cardiovasc Diabetol 21, 257 (2022).
https://doi.
org/10.
1186/s12933-022-01652-z