Flora Özkalaycı1, Ali Karagöz2, Işıl Kutlutürk Karagöz3, Süleyman Çağan Efe2, Erdem Türkyılmaz2, İbrahim Halil Tanboğa4, Cihangir Kaymaz2

1Department of Cardiology, Hisar Intercontinental Hospital, Istanbul, Turkey
2Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
3Department of Ophtalmology, Umraniye Training and Research Hospital, Istanbul, Turkey
4Department of Cardiology, Faculty of Medicine, University of Nisantasi, Istanbul, Turkey

Keywords: CONUT score; diabetes mellitus; left atrial strain


Introduction: Malnutrition is a serious public health problem that is associated with adverse outcomes in a broad range of disease including cardiovascular disease and diabetes mellitus. Malnutrition is demonstrated to be accompanying to several disease, yet there is a lack of evidence on the impact of malnutrition on cardiac functions in patients with diabetic patients with diabetic retinopathy. Herewith our primary goal was to evaluate the relation between any degree malnutrition with left atrial strain in relevant patient group.
Patients and Methods: Patients with diabetes mellitus with retinopathy, who were referred to the outpatient cardiology clinic were assessed. Those who had sinus rhythm, had no findings of significant valvular heart disease or coronary artery disease underwent to 2-dimensional speckle tracking echocardiography and assessed for malnutrition in their prior examinations were included to the study. Hundred and seventy patients met the inclusion criteria. Malnutrition scores such as Controlling Nutritional Status score (CONUT), nutritional risk index (NRI) and The Prognostic Nutritional Index score (PNI) index were used to evaluate nutrition condition of the patients.
Results: Thirty percent of all diabetic patients were demonstrated to have malnutrition according to the CONUT score. Left atrial conduit strain was demonstrated to decrease [ß: -7.5 (CI 95%, -10.7, -4.3 p< 0.001)], Left atrial reservoir strain was demonstrated to increase [ß: 2.48 (CI 95%,0.83-4.13 p< 0.03)] and Left atrial contractile strain was demonstrated to decrease [ß: -4.21 (CI 95%, -2.21, -6.01 p< 0.001)] in the presence of any degree malnutrition.
Conclusion: In this study we have demonstrated that malnutrition is an important entity in patients with diabetes mellitus and has a significant impact on left atrial strain.

Ethics Committee Approval

This study was approved by Kartal Kosuyolu High Specialization Training and Research Hospital Ethics Committee (5, Date: 12.12.2019).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - CK; Analysis/Interpretation - AK, IK; Data Collection - SE; Writing - FÖ; Critical Revision - FÖ, AK; Statistical Analysis - İT, AK; Overall Responsibility - FÖ; Final Approval - All of Authors.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declared that this study has received no financial support.