Combined with the insulin resistance index in assessing subclinical systolic function in newly diagnosed type 2 diabetes mellitus:An analysis based on automated functional imaging echocardiography

Background: In recent years, simpler and more practical indicators based on routine biochemical tests or anthropometric measurements have been widely utilized for the assessment of insulin sensitivity. However, limited research has been conducted to investigate the predictive value of these novel simplified measures in relation to subclinical left ventricular systolic dysfunction. Methods: A total of 160 newly diagnosed patients with type 2 diabetes mellitus (T ₂ DM) and 70 healthy subjects matched by age and sex were included in the study. Left ventricular function parameters were assessed using AFI echocardiography. Four indicators of insulin resistance (IR) were computed: Triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c), the product of fasting triglycerides and glucose levels(TyG), TyG multiplied by the body mass index(TyG-BMI)and the Insulin resistance metabolic score(METS-IR). The binary logistic regression analysis identified clinical and ultrasonic risk factors associated with abnormal GLPS-AVG in patients with T2DM. Develop a multiple-index-based log P model for integrated application. The diagnostic efficacy of the log P model in predicting left ventricular systolic function impairment was assessed using ROC analysis. Results: Competing risk regression revealed that BMI, IVSD, SBP and LA were significant risk factors for the reduction of GLPS-AVG in individuals with T ₂ DM. Additionally, two IR index models were found to be closely associated with abnormal GLPS-AVG: TyG-BMI (6.227,p=0.000); METS-IR(7.436,p=0.000). ROC analysis results indicate that TyG-BMI, METS-IR, IVSD, SBP, LA and a combination of five other indexes have demonstrated certain efficacy in predicting and evaluating diabetic heart function reduction. Its ROC-AUC (0.95CI) are 0.750 (0.564 ~ 0.934), 0.774 (0.582 ~ 0.944), 0.702 (0.461 ~ 0.948), 0.737 (0.478 ~ 0.983), 0.726 (0.483 ~ 0.951), 0.878 (0.770 ~ 0.987) respectively. Conclusion: Approximately 20% of newly diagnosed patients with T ₂ DM exhibit early-stage left ventricular systolic dysfunction.The Log P model exhibited the highest predictive efficiency when applied in combination, with significantly higher sensitivity, specificity and accuracy than each individual application.