Abstract

Diabetes mellitus (DM) is known to be associated with serious cardiovascular risk and the prevalence of DM amongst population is rapidly increasing. When important risk factors such as age, hypercholesterolemia, obesity and coronary artery disease are excluded, DM still continues to be an important risk factor for cardiovascular disease. Diastolic dysfunction is an early complication of type 2 diabetes and diabetic cardiomyopathy is known to be the first step of the process. Diabetic cardiomyopathy is progressive, it leads to a decrease in systolic and diastolic functions; and, without clinical signs, and diastolic dysfunction can be detected by echocardiography where tissue Doppler studies and left atrial volume measurements could be performed. As prediabetes holds a potential risk for development of type 2 diabetes; in the same way, it possesses microvascular and cardiovascular risk factors. The association of type 2 diabetes with left ventricular function and diastolic dysfunction has been explored in many studies. But, studies on relationship of prediabetes, subgroups of prediabetes and insulin resistance with left ventricular function are limited; therefore, investigation of diastolic function in patients with prediabetes was aimed in this study. Prediabetic patients with normal hypertension, between the ages of 18-50, who do not have any other systemic disease, were included in the study and echocardiography investigation was carried out on all patients. Diastolic dysfunction was detected in 10 patients. Diastolic dysfunction and HOMA-IR levels (p = 0.002), triglyceride levels (p = 0.003) and the presence of insulin resistance (p = 0.001) demonstrated a statistically significant correlation with diastolic dysfunction. However impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) revealed no statistically significant correlation with the presence of diastolic dysfunction. Diastolic dysfunction is one of the major concerns in cardiovascular disease; and, can be detected with standard Doppler echocardiography investigation in prediabetes patients. Changes associated with diastolic dysfunction demonstrated a particularly strong relationship with higher HOMA-IR levels. Especially in patients with pre-diabetes or insulin resistance, importance of detailed echocardiography investigation should be emphasized. Early detection and primary prevention of cardiovascular disease could be enhanced with the use of echocardiography investigation.

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