Early marker to defect cardiac dysfunction in patients with type 1 diabetes mellitus and effect of exercise

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K17096
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Juntendo University
• Principal Investigator: Iso Takeshi 順天堂大学, 医学部, 助教 (80868191)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 1型糖尿病 / 糖尿病性心筋症 / 心臓超音波検査 / 心拍変動解析 / 機械学習

Outline of Final Research Achievements

The aim of this study was to investigate diabetic cardiomyopathy in type 1 diabetic patients with high incidence of heart failure and mortality from cardiovascular events by examining new echocardiographic indices and terminal glycation products to identify pathogenic mechanisms and markers for early detection, and to determine whether exercise therapy intervention contributes to improved prognosis. However, the prevalence of COVID-19 made echocardiography and exercise prescription difficult, so we decided to proceed with the study by incorporating heart rate variability and activity as new methods of cardiac function evaluation and machine learning as a new analysis method. The validation of the usefulness of each evaluation and analysis method has been completed, and we will resume echocardiographic examinations to confirm changes in cardiac function evaluation and exercise prescription from various angles, including the conventional plan.

Free Research Field

循環器学

Academic Significance and Societal Importance of the Research Achievements

糖尿病は生活習慣病として現在でも発症患者は増加してきている。発症後は継続的な血糖コントロール治療だけでなく合併症に対する治療が必要になり、多くの社会的資源が注ぎ込まれている。合併症の一つとして心血管イベントがある。今回の研究で(1)心臓超音波のどの指標が早期に心機能低下を反映するか、(2) AGEsは心機能評価の代用となりうるか、(3)運動療法は心機能に寄与するか、を明らかにし、心合併症の早期発見および運動療法の効果についての重要なデータを提供できる。その結果、T1DM患者の生命予後が改善し、社会的には医療費の削減に結びつくことが期待できる。