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Background: Type 2 diabetes mellitus (T2DM) is a recognized trigger factor for heart failure with preserved ejection fraction (HFpEF). Recent studies show that higher serum calcium level is associated with greater risk of both T2DM and heart failure. We speculate that increased serum calcium is related to HFpEF prevalence in patients with T2DM., Methods: In this cross-sectional echocardiographic study, 807 normocalcemia and normophosphatemia patients with T2DM participated, of whom 106 had HFpEF. Multinomial logistic regression was carried out to determine the variables associated with HFpEF. The associations between serum calcium and metabolic parameters, as well as the rate of HFpEF were examined using bivariate linear correlation and binary logistic regression, respectively. The predictive performance of serum calcium for HFpEF was evaluated using the area under the receiver operating characteristic curve (AUC)., Results: Patients with HFpEF have significantly higher serum calcium than those without HFpEF. Serum calcium was positively associated with total cholesterol, triglycerides, low-density lipoprotein cholesterol, serum uric acid, HOMA-IR and fasting plasma glucose. Compared with patients in the lowest serum calcium quartile, the odds ratio (OR) for HFpEF in patients in the highest quartile was 2.331 (95 % CI 1.088-4.994, p = 0.029). When calcium was analyzed as a continuous variable, per 1 mg/dL increase, the OR (95 % CI) for HFpEF was [2.712 (1.471-5.002), p = 0.001]. Serum calcium can predict HFpEF [AUC = 0.673, 95 % CI (0.620-0.726), p < 0.001]., Conclusions: An increase in serum calcium level is associated with an increased risk of HFpEF in patients with T2DM.

Background: Left ventricular hypertrophy (LVH) is prevalent in patients with type 2 diabetes mellitus (T2DM). Recent studies show that an increase in albumin-adjusted serum calcium level is associated with an elevated risk of T2DM. We speculate that increased serum calcium levels in T2DM patients are related to LVH prevalence., Methods: In this echocardiographic study, 833 normocalcemia and normophosphatemia patients with T2DM were enrolled. The associations between serum calcium and metabolic parameters, left ventricular mass index (LVMI), as well as the rate of LVH were examined using bivariate linear correlation, multivariate linear regression and logistic regression, respectively. The predictive performance of serum calcium for LVH was evaluated using the area under the receiver operating characteristic curve (AUC)., Results: Patients with LVH have significantly higher serum calcium than those without LVH. Serum calcium was positively associated with total cholesterol, triglycerides, low-density lipoprotein cholesterol, serum uric acid, HOMA-IR and fasting plasma glucose. Multivariate linear regression analysis demonstrated that serum calcium was independently associated with LVMI (p < 0.001). In comparison with patients in the lowest serum calcium quartile, the odds ratio (OR) for LVH in patients in the highest quartile was 2.909 (95% CI 1.792-4.720; p < 0.001). When serum calcium was analyzed as a continuous variable, per 1 mg/dl increase, the OR (95% CI) for LVH was [2.400 (1.552-3.713); p < 0.001]. Serum calcium can predict LVH (AUC = 0.617; 95% CI (0.577-0.656); p < 0.001)., Conclusions: Albumin-adjusted serum calcium is associated with an increased risk of LVH in patients with T2DM.

Background: Cardiac autonomic neuropathy (CAN) is a common complication of type 2 diabetes mellitus (T2DM). Brachial-ankle pulse wave velocity (baPWV) is known to be a good surrogate marker of vascular damages. The goal of this study was to investigate the relationship between BaPWV and CAN in T2DM., Methods: A total of 148 patients who had no apparent history of cardiovascular condition were enrolled consecutively in this study. The correlation between increased baPWV and CAN was analyzed. CAN was evaluated by five standard cardiovascular reflex tests (CARTs) according to the Ewing's protocol: 1) heart rate variation during deep breathing, 2) heart rate response to standing, 3) Valsalva maneuver, 4) postural systolic blood pressure (BP) change, 5) Sustained handgrip test. CAN was defined as the presence of at least two abnormal tests., Results: The mean age of patients was 59.8 ± 7.8 years. The mean duration of diabetes was 6.0(2.0-11.0) years. The mean baPWV was 1665.5(1482.0-1940.0) cm/sec. Subjects with CAN were older and had high BMI, baPWV compared with those without CAN. The proportion of patients with diabetic peripheral neuropathy was higher in subjects with CAN. After adjusting for other confounding risk factors, baPWV (odds ratio = 8.496, 95% CI: 1.216-59.348; P = 0.031) remained as independent risk factors for CAN. The number of abnormal CARTs increased gradually with increasing baPWV (correlation coefficient =0.255, p = 0.002)., Conclusion: Increased baPWV was significantly correlated with CAN in patients with type 2 diabetes.

Background: Serum lipids and the ratios are known to be associated with the cardiovascular diseases (CVD). However, the associations of serum lipids and the ratios related to arterial stiffness are unclear. We sought to compare the strength of these serum lipids and the ratios with arterial stiffness assessing by brachial-ankle pulse wave velocity (baPWV) in the middle-aged and elderly Chinese subjects., Methods: A total number of 1133 Chinese aged from 50 to 90 years old were recruited from Shanghai downtown district. The serum lipids, baPWV and major cardiovascular risk factors of the participants were measured., Results: Participants with high baPWV exhibited higher levels of non-HDL-c, TC/HDL-c, TG/HDL-c, LDL-c/HDL-c, and non-HDL-c/HDL-c, while HDL-c worked in the opposite direction (all P<0.05). In addition, TC, TG, LDL-c, non-HDL-c, TC/HDL-c, TG/HDL-c, LDL-c/HDL-c, and non-HDL-c/HDL-c had a positive relationship with the baPWV value, while HDL-c was on the contrary (all P <0.05). Finally, individuals with high non-HDL-c/HDL-c (OR 1.71, 95% CI 1.06-2.55, P = 0.013) and low HDL-c (OR 0.57, 95% CI 0.35-0.96, P = 0.024) were seem to be at high risk of arterial stiffness., Conclusions: As a risk indicator, non-HDL-c/HDL-c, which could be readily obtained from routine serum lipids, was significantly associated with baPWV. Non-HDL-c/HDL-c was superior to traditional lipid variables for estimating arterial stiffness in the middle-aged and elderly Chinese population.