Introduction
Subjects, materials, and methods
Patients
Baseline clinical and metabolic data
Follow-up
Echocardiography protocols
Two-dimensional and Doppler echocardiography
Left ventricular strain imaging
Left atrial volume and function assessment
Calibrated integrated backscatter
Statistical analysis
Results
Baseline clinical, metabolic, and echocardiographic characteristics
Characteristic | Group 1: no weight loss + worse glycaemic control (n = 20) | Group 2: no weight loss + improved glycaemic control (n = 20) | Group 3: weight loss + improved glycaemic control (n = 10) |
---|---|---|---|
Body mass index (kg/m2) | |||
Baseline | 34.4 (31.2–37.5) | 31.5 (28.3–34.7) | 44.3 (39.8–48.7)§†
|
Follow-up | 35.7 (32.5–38.8) | 32.5 (29.4–35.7)* | 34.5 (30.0–40.0)* |
Weight (kg) | |||
Baseline | 92.1 (82.1–102.0) | 81.3 (71.3–91.2) | 123.6 (109.5–137.7)§†
|
Follow-up | 94.2 (85.1–103.3)* | 84.3 (75.2–93.4)* | 95.7 (82.8–108.5)* |
Waist circumference (cm) | |||
Baseline | 109 (102, 115) | 103 (96, 109)§
| 128 (119, 137)†
|
Follow-up | 111 (104, 117) | 105 (99, 111) | 114 (106, 122)* |
Waist-to-hip ratio | |||
Baseline | 0.94 (0.91–0.98) | 0.95 (0.91–0.99) | 0.94 (0.89–0.99) |
Follow-up | 0.94 (0.91–0.96) | 0.96 (0.93–0.99) | 0.96 (0.92–1.00) |
Systolic blood pressure (mmHg) | |||
Baseline | 137 (129–144) | 133 (125–140) | 128 (117–138) |
Follow-up | 134 (128–140) | 129 (123–135) | 131.4 (123–140) |
Diastolic blood pressure (mmHg) | |||
Baseline | 78 (73–82) | 73 (68–78) | 74 (68–81) |
Follow-up | 81 (77–86) | 77 (72–81) | 79 (72–85) |
HbA1c, NGSP (%) IFCC (mmol/mol) | |||
Baseline | 9.4 (8.6–10.2) | 9.9 (9.1–10.7) | 9.5 (8.4–10.6) |
79 (70–88) | 85 (76–93) | 80 (68–92) | |
Follow-up | 9.5 (8.7–10.3) | 7.3 (6.5–8.1)*†
| 6.7 (5.5–7.1)*†
|
80 (72–89) | 56 (48–65) | 50 (37–54) | |
Total cholesterol (mg/dL) | |||
Baseline | 5.2 (4.7–5.7) | 4.1 (3.5–4.6)†
| 5.0 (4.3–5.8) |
Follow-up | 4.8 (4.3–5.4) | 3.8 (3.2–4.3)†
| 4.6 (3.9–5.4) |
LDL cholesterol (mg/dL) | |||
Baseline | 2.7 (2.2–3.3) | 1.8 (1.5–2.1)†
| 2.6 (2.0–3.4) |
Follow-up | 2.3 (1.8–2.1) | 1.8 (1.4–2.2) | 2.5 (1.8–3.3) |
HDL cholesterol (mg/dL) | |||
Baseline | 1.2 (1.1–1.4) | 1.3 (1.2–1.4) | 1.09 (0.9–1.3) |
Follow-up | 1.2 (1.1–1.3) | 1.2 (1.1–1.3) | 1.2 (1.1–1.4)* |
Triglycerides (mg/dL) | |||
Baseline | 1.7 (1.4–2.2) | 1.3 (1.1–1.6) | 2.2 (1.5–3.2) |
Follow-up | 1.7 (1.4–2.2) | 1.2 (1.0–1.5) | 1.4 (1.1–1.9) |
eGFR (mL/min/1.73 m2) | |||
Baseline | 91 (83–99) | 92 (84–99) | 89 (78–100) |
Follow-up | 101 (93–110) | 84 (75–92) | 96 (84–108) |
C-reactive protein (mg/L) | |||
Baseline | 3.6 (2.2–5.9) | 3.0 (1.8–5.1) | 10.2 (5.2–19.8) |
Follow-up | 2.8 (1.8–4.4) | 2.7 (1.7–4.4) | 4.4 (2.3–8.4) |
Medication | Group 1: no weight loss + worse glycaemic control (n = 20) | Group 2: no weight loss + improved glycaemic control (n = 20) | Group 3: weight loss + improved glycaemic control (n = 10) |
---|---|---|---|
Aspirin or clopidogrel, n (%) | 10 (25 %) | 16 (40 %) | 4 (20 %) |
Angiotensin converting enzyme inhibitor or angiotensin-II receptor blocker, n (%) | 32 (80 %) | 26 (65 %) | 16 (80 %) |
Calcium channel blocker, n (%) | 0 (0 %) | 6 (15 %) | 6 (30 %) |
Beta-blocker, n (%) | 2 (5 %) | 4 (10 %) | 0 (0 %) |
Diuretic, n (%) | 6 (15 %) | 2 (5 %) | 4 (20 %) |
Spironolactone, n (%) | 0 (0 %) | 2 (5 %) | 0 (0 %) |
Statin, n (%) | 28 (70 %) | 26 (65 %) | 10 (50 %) |
Sulfonylurea, n (%) | 6 (15 %) | 20 (50 %) | 6 (30 %) |
Biguanide, n (%) | 38 (95 %) | 32 (80 %) | 18 (90 %) |
Di-peptidyl peptidase-4 inhibitor , n (%) | 10 (26 %) | 8 (20 %) | 4 (20 %) |
Insulin, n (%) | 20 (50 %) | 16 (40 %) | 10 (50 %) |
Characteristic | Group 1: no weight loss + worse glycaemic control (n = 20) | Group 2: no weight loss + improved glycaemic control (n = 20) | Group 3: weight loss + improved glycaemic control (n = 10) |
---|---|---|---|
LV mass index (g/m2) | |||
Baseline | 78.9 (68.6–89.3) | 93.5 (83.1–103.9) | 90.1 (75.4–104.8) |
Follow-up | 83.3 (75.5–91.0) | 89.2 (81.4–97.0) | 75.6 (64.6–86.5) |
LV end diastolic volume (mL) | |||
Baseline | 67 (58–80) | 66 (54–78) | 89 (72–106) |
Follow-up | 71 (60–82) | 64 (53–76) | 91 (75–107) |
LV end systolic volume (mL) | |||
Baseline | 24 (18–31) | 27 (20–34) | 36 (26–45) |
Follow-up | 23 (18–27) | 20 (15–24) | 29 (22–35) |
LVEF (%) | |||
Baseline | 65 (62–69) | 61 (58–65) | 60 (54–65) |
Follow-up | 69 (66–72) | 70 (66–73)* | 69 (64–73)* |
E (cm/s) | |||
Baseline | 74 (67–83) | 67 (61–75) | 70 (61–82) |
Follow-up | 80 (72–88) | 75 (68–82) | 73 (64–83) |
A (cm/s) | |||
Baseline | 87 (78–96) | 72 (63–81) | 82 (70–95) |
Follow-up | 88 (80–96) | 73 (66–81) | 80 (69–91) |
E/A | |||
Baseline | 1.06 (0.98–1.13) | 1.03 (0.95–1.10) | 1.07 (0.96–1.18) |
Follow-up | 1.06 (0.99–1.12) | 1.00 (0.93–1.07) | 1.07 (0.97–1.17) |
Septal s’ (cm/s) | |||
Baseline | 7.0 (6.4–7.6) | 6.5 (5.9–8.1) | 6.1 (5.3–6.9) |
Follow-up | 6.8 (6.3–7.3) | 6.5 (6.0–7.0) | 6.5 (5.7–7.3) |
Septal e’ (cm/s) | |||
Baseline | 6.3 (5.8–6.7) | 6.1 (5.6–6.6) | 5.9 (5.2–6.6) |
Follow-up | 6.6 (5.7–7.4) | 7.5 (6.6–8.3)* | 8.2 (7.0–9.4)* |
Septal a’ (cm/s) | |||
Baseline | 9.6 (8.5–10.6) | 8.8 (7.7–9.8) | 8.8 (7.3–10.3) |
Follow-up | 9.2 (8.3–10.1) | 8.1 (7.2–9.0) | 8.2 (7.0–9.4) |
Septal E/e’ | |||
Baseline | 11.9 (10.7–13.5) | 11.1 (10–12.5) | 11.9 (10.2–14.2) |
Follow-up | 12.3 (10.7–14.5) | 10.2 (9.1–11.6) | 9.0 (7.8–10.7)* |
LA dimension (mm) | |||
Baseline | 35 (33, 38) | 35 (33, 38) | 39 (46, 42) |
Follow-up | 36 (34, 38) | 33 (31, 35) | 33 (30, 36)* |
LA maximum volume indexed (mL/m2) | |||
Baseline | 26 (24–28) | 28 (26–32) | 28 (24–32) |
Follow-up | 27 (24–31) | 28 (25–31) | 30 (25–36) |
LA active emptying volume indexed (mL/m2) | |||
Baseline | 10 (9–12) | 10 (8–11) | 9 (7–11) |
Follow-up | 10 (8–11) | 10 (8–11) | 12 (10–14) |
LA passive emptying volume indexed (mL/m2) | |||
Baseline | 9 (8–11) | 11 (9–13) | 13 (11–15) |
Follow-up | 11 (9–14) | 11 (9–13) | 11 (8–14) |
Anteroseptal wall cIB (dB) | |||
Baseline | −14.1 (−16.6 to 11.6) | −10.6 (−13.1 to 8.1) | −6.0 (−9.6 to 2.5)† |
Follow-up | −14.1 (−16.4 to 11.8) | −12.5 (−14.8 to 10.2) | −13.1 (−16.4 to 9.8)* |
Posterior wall cIB (dB) | |||
Baseline | −16.5 (−19.0 to 14.1) | −12.1 (−14.5 to 9.6) | −11.7 (−15.2 to 8.3) |
Follow-up | −16.6 (−18.8 to 14.5) | −15.3 (−17.4 to 13.2) | −13.9 (−16.9 to 10.9)* |
LV global longitudinal systolic strain (%) | |||
Baseline | −17.3 (−18.6 to 16.0) | −15.3 (−16.6 to 14.0) | −13.0 (−14.8 to 11.2)† |
Follow-up | −17.9 (−19.0 to 16.8) | −19.4 (−20.5 to 18.3)* | −19.3 (−18.9 to 17.8)* |
LV global longitudinal systolic strain rate (1/s) | |||
Baseline | −0.99 (−1.06 to 0.91) | −0.82 (−0.89 to 0.74)† | −0.77 (−0.87 to 0.66)† |
Follow-up | −0.98 (−1.05 to 0.91) | −1.03 (−1.1 to 0.96)* | −0.99 (−1.1 to 0.89)* |