Table_1_Plasma Low-Density Lipoprotein Cholesterol Correlates With Heart Function in Individuals With Type 2 Diabetes Mellitus: A Cross-Sectional Study.xlsx

Background: Heart failure is a frequent complication of type 2 diabetes mellitus (T2DM). Plasma cholesterol, particularly the proatherogenic low-density lipoprotein (LDL) cholesterol, impairs heart function by promoting atheroma formation and ventricular dysfunction. Considering the established effect of cholesterol on the cardiovascular system, we hypothesized that plasma LDL cholesterol may influence left ventricular function in individuals with T2DM.
Methods: This cross-sectional study was conducted at a tertiary care hospital in Taiwan. Enrollment criteria were patients exceeding 21 years of age with T2DM who received antidiabetic and cholesterol-lowering medications. Candidates were excluded if they had heart failure, acute cardiovascular events, or familial hypercholesterolemia. Participants received blood sampling for plasma lipids after a 12-h fast, followed by transthoracic echocardiography in the cardiology clinic.
Results: The study enrolled 118 participants who were divided into two groups according to their plasma LDL cholesterol levels. Demographic characteristics including age (69.7 vs. 66.9 years, P = 0.159), body mass index (26.2 vs. 25.9 kg/m2, P = 0.66), diabetes duration (5.4 vs. 5.1 years, P = 0.48), hemoglobin A1c (7.2 vs. 7.5%, P = 0.225), and systolic blood pressure (129 vs. 130 mm Hg, P = 0.735) were similar between these groups. Moreover, all participants received similar antihypertensive medications. Participants with lower plasma LDL cholesterol levels had better heart function, as measured by the left ventricular ejection fraction (LVEF), than patients with higher LDL cholesterol levels (58.0 vs. 50.5%, P = 0.022). Multivariate regression analysis also showed an inverse correlation between plasma LDL cholesterol and left ventricular function (β coefficient: −0.110, P = 0.024).
Conclusion: This study observed an inverse correlation between plasma LDL cholesterol and heart function in individuals with T2DM. Patients with higher levels of plasma LDL cholesterol had worse left ventricular function. Therefore, plasma LDL cholesterol may be a modifiable risk factor of heart failure in diabetes, but prospective studies are necessary to confirm this finding.

背景：心力衰竭是2型糖尿病（type 2 diabetes mellitus, T2DM）的常见并发症。血浆胆固醇，尤其是致动脉粥样硬化性低密度脂蛋白（low-density lipoprotein, LDL）胆固醇，可通过促进动脉粥样斑块形成与心室功能障碍损害心脏功能。鉴于胆固醇对心血管系统的既定作用，我们提出假设：血浆低密度脂蛋白胆固醇可能影响2型糖尿病患者的左心室功能。
方法：本横断面研究于中国台湾某三级医院开展。纳入标准为年龄超过21岁、确诊2型糖尿病且接受降糖与降脂药物治疗的患者。排除标准为合并心力衰竭、急性心血管事件或家族性高胆固醇血症的受试者。所有受试者于空腹12小时后采集血液样本以检测血浆脂质水平，随后在心脏科门诊接受经胸超声心动图检查。
结果：本研究共纳入118名受试者，根据血浆低密度脂蛋白胆固醇水平分为两组。两组的人口统计学特征无显著差异，包括年龄（69.7 vs 66.9岁，P = 0.159）、体质量指数（26.2 vs 25.9 kg/m²，P = 0.66）、糖尿病病程（5.4 vs 5.1年，P = 0.48）、糖化血红蛋白（7.2 vs 7.5%，P = 0.225）及收缩压（129 vs 130 mm Hg，P = 0.735）。此外，所有受试者的降压药物使用方案相似。血浆低密度脂蛋白胆固醇水平较低的受试者，其左心室射血分数（left ventricular ejection fraction, LVEF）所评估的心脏功能优于低密度脂蛋白胆固醇水平较高的受试者（58.0% vs 50.5%，P = 0.022）。多变量回归分析同样显示，血浆低密度脂蛋白胆固醇与左心室功能呈负相关（β系数：−0.110，P = 0.024）。
结论：本研究发现，2型糖尿病患者的血浆低密度脂蛋白胆固醇水平与心脏功能呈负相关。血浆低密度脂蛋白胆固醇水平较高的患者，其左心室功能更差。因此，血浆低密度脂蛋白胆固醇或可成为糖尿病患者心力衰竭的可干预危险因素，但仍需开展前瞻性研究以验证该研究结论。