The role of Cardiotrophin-1 and echocardiography in early detection of subclinical diabetic cardiomyopathy in children and adolescents with type 1 diabetes mellitus

Samah A. Hassanein; Mona M. Hassan; Mohamed Samir; Mahmoud O. Aboudeif; Mohamed S. Thabet; Mona Abdullatif; Dina Khedr

doi:10.1515/jpem-2024-0323

Article

The role of Cardiotrophin-1 and echocardiography in early detection of subclinical diabetic cardiomyopathy in children and adolescents with type 1 diabetes mellitus

Samah A. Hassanein , Mona M. Hassan , Mohamed Samir , Mahmoud O. Aboudeif , Mohamed S. Thabet , Mona Abdullatif and Dina Khedr

Published/Copyright: September 3, 2024

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 37 Issue 10

Abstract

Objectives

To assess the role of Cardiotrophin-1 (CT-1) and echocardiography in early detection of subclinical Diabetic Cardiomyopathy (DCM) in children with type 1 Diabetes Mellitus (T1D).

Methods

This case-control study included two groups of children and adolescents aged between 7 and 18. Group (1) included forty patients with T1D (duration > 5 years) regularly followed at the children's hospital of Cairo University, and Group (2) included forty age and sex-matched healthy subjects as a control group. The serum level of CT-1 was measured, and conventional echocardiography, tissue Doppler imaging (TDI), and 2D speckle tracking echocardiography were performed.

Results

The level of CT-1 in the cases ranged from 11 to 1039.4 pg/ml with a median (IQR) of 19.4 (16.60–25.7) pg/ml, while its level in the control group ranged from 10.8 to 162.6 pg/ml with a median (IQR) of 20.2 (16.2–24.8) pg/ml. CT-1 levels showed no statistically significant difference between cases and controls. Patients had significantly higher mean left ventricle E/E′ ratio (p<0.001), lower mean 2D global longitudinal strain (GLS) of the left ventricle (LV) (p<0.001), and lower mean GLS of the right ventricle (RV) (p<0.001) compared to controls. Ofpatients with diabetes, 75 % had LV diastolic dysfunction, 85 % had RV diastolic dysfunction, 97.5 % had LV systolic dysfunction, and 100 % had RV systolic dysfunction.

Conclusions

Non-conventional echocardiography is important for early perception of subclinical DCM in patients with T1D. CT-1 was not specific for early detection of DCM.

Keywords: diabetic cardiomyopathy; Cardiotrophin-1; tissue Doppler imaging; speckle tracking echocardiography

Corresponding author: Dina Khedr, MD, Lecturer, Pediatrics and Pediatric Endocrinology, Diabetes Endocrinology and Metabolism Pediatric Unit (DEMPU), Department of Pediatrics, Faculty of Medicine, Cairo University, Kasralainy Street, Cairo, 12411, Egypt, E-mail: Drdinakhedr@cu.edu.eg

Research ethics: The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and approved by the Scientific Ethics Committee of the Pediatric Department, Faculty of Medicine, Cairo University on 12/10/2019 with code number: MD-92-2019.
Informed consent: Informed consent was obtained from all individuals included in this study, or their legal guardians or wards.
Author contributions: Prof. Mona Hassan A conceived the study, participated in its design, supervised data collection from the patients, and helped to draft the manuscript. Samah Hassanein participated in study design and coordination and helped to draft the manuscript. Dina Khedr participated in the study design and coordination and helped to draft the manuscript. Mohamed Samir participated in the study design and coordination and helped to draft the manuscript. Mahmoud Othman Aboudeif participated in the study design and coordination and helped to draft the manuscript. Mona Abdullatif participated in the study design, supervised collection of data and laboratory work, and helped to draft the manuscript. Mohamed Thabet participated in patient selection and data collection. All authors read and approved the manuscript.
Competing interests: The authors state no conflict of interest.
Research funding: None declared.
Data availability: The raw data can be obtained on request from the corresponding author

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Received: 2024-07-07

Accepted: 2024-08-16

Published Online: 2024-09-03

Published in Print: 2024-10-28

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Articles in the same Issue

https://doi.org/10.1515/jpem-2024-0323

Keywords for this article

diabetic cardiomyopathy; Cardiotrophin-1; tissue Doppler imaging; speckle tracking echocardiography