J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Original Article

Volume 17, Number 5, May 2025, pages 262-269

Left Ventricular Diastolic Dysfunction and Its Predictive Factors Among Saudi Patients With Type 2 Diabetes Mellitus

↓ **Table 1.** Demographic and Clinical Characteristics
Parameter	Mean ± SD or n (%)
ACEi: angiotensin-converting enzyme inhibitor; ARBs: angiotensin II receptor blockers; BMI: body mass index; CVA: cerebral vascular accident; DBP: diastolic blood pressure; DM: diabetes mellitus; DPP4i: dipeptidyl peptidase 4 inhibitor; eGFR: estimated glomerular filtration rate; FBS: fasting blood sugar; GLP-1: glucagon-like peptide 1; HbA1c: glycated hemoglobin; HDL: high-density lipoprotein; HTN: hypertension; LDL: low-density lipoprotein; PVD: peripheral vascular disease; SBP: systolic blood pressure; TG: triglyceride.
Age (years)	59.47 ± 9.11
Gender
Male	96 (38.2)
Female	155 (61.8)
DM duration (years)	20.28 ± 8.49
HTN	193 (76.9)
Dyslipidemia	203 (81.2)
Diabetic nephropathy	22 (8.8)
Diabetic neuropathy	11 (4.4)
Diabetic retinopathy	23 (9.2)
CVA	33 (13.1)
PVD	12 (4.8)
Height (cm)	158.9 ± 9.06
Weight (kg)	83.26 ± 16.5
BMI (kg/m²)	32.9 ± 6.6
SBP (mm Hg)	134.55 ± 23.88
DBP (mm Hg)	72.83 ± 12.55
FBS (mmol/L)	9.15 ± 4.85
HbA1c (%)	7.76 ± 2.33
Total cholesterol (mmol/L)	4.12 ± 1.06
HDL (mmol/L)	1.27 ± 0.35
LDL (mmol/L)	2.30 ± 0.8
TG (mmol/L)	1.64 ± 0.79
Creatinine (mmol/L)	73.88 ± 23.22
eGFR (mL/min/1.73 m²)	88.02 ± 21.06
Metformin	207 (82.5)
Sulfonylureas	52 (20.7)
Insulin	117 (46.6)
DPP4i	105 (41.8)
Thiazolidinediones	17 (6.8)
GLP-1 analogues	13 (5.2)
Alpha-glucosidase inhibitors	1 (0.4)
ARBs/ACEi	156 (62.2)
Beta-blockers	88 (35.1)
Diuretics	112 (44.6)
Calcium channel blocker	92 (36.7)
Antiplatelet agent	148 (69.2)
Lipid-lowering agent	221 (88.0)

↓ Table 1. Demographic and Clinical Characteristics

Parameter

Mean ± SD or n (%)

ACEi: angiotensin-converting enzyme inhibitor; ARBs: angiotensin II receptor blockers; BMI: body mass index; CVA: cerebral vascular accident; DBP: diastolic blood pressure; DM: diabetes mellitus; DPP4i: dipeptidyl peptidase 4 inhibitor; eGFR: estimated glomerular filtration rate; FBS: fasting blood sugar; GLP-1: glucagon-like peptide 1; HbA1c: glycated hemoglobin; HDL: high-density lipoprotein; HTN: hypertension; LDL: low-density lipoprotein; PVD: peripheral vascular disease; SBP: systolic blood pressure; TG: triglyceride.

Age (years)

59.47 ± 9.11

Gender

Male

96 (38.2)

Female

155 (61.8)

DM duration (years)

20.28 ± 8.49

HTN

193 (76.9)

Dyslipidemia

203 (81.2)

Diabetic nephropathy

22 (8.8)

Diabetic neuropathy

11 (4.4)

Diabetic retinopathy

23 (9.2)

CVA

33 (13.1)

PVD

12 (4.8)

Height (cm)

158.9 ± 9.06

Weight (kg)

83.26 ± 16.5

BMI (kg/m²)

32.9 ± 6.6

SBP (mm Hg)

134.55 ± 23.88

DBP (mm Hg)

72.83 ± 12.55

FBS (mmol/L)

9.15 ± 4.85

HbA1c (%)

7.76 ± 2.33

Total cholesterol (mmol/L)

4.12 ± 1.06

HDL (mmol/L)

1.27 ± 0.35

LDL (mmol/L)

2.30 ± 0.8

TG (mmol/L)

1.64 ± 0.79

Creatinine (mmol/L)

73.88 ± 23.22

eGFR (mL/min/1.73 m²)

88.02 ± 21.06

Metformin

207 (82.5)

Sulfonylureas

52 (20.7)

Insulin

117 (46.6)

DPP4i

105 (41.8)

Thiazolidinediones

17 (6.8)

GLP-1 analogues

13 (5.2)

Alpha-glucosidase inhibitors

1 (0.4)

ARBs/ACEi

156 (62.2)

Beta-blockers

88 (35.1)

Diuretics

112 (44.6)

Calcium channel blocker

92 (36.7)

Antiplatelet agent

148 (69.2)

Lipid-lowering agent

221 (88.0)

↓ **Table 2.** Comparison of Patients’ Categorial Characteristics According to the Presence of LVDD
Patients’ characteristics	LVDD	P-value
*P ≤ 0.05. ACEi: angiotensin-converting enzyme inhibitor; ARBs: angiotensin II receptor blockers; CVA: cerebral vascular accident; DPP4i: dipeptidyl peptidase 4 inhibitor; GLP-1: glucagon-like peptide 1; HTN: hypertension; LVDD: left ventricular diastolic dysfunction; PVD: peripheral vascular disease.
Gender					0.534
Male	34	41.0%	62	36.9%
Female	49	59.0%	106	63.1%
HTN	50	60.2%	143	85.1%	0.000*
Dyslipidemia	64	77.1%	139	83.2%	0.243
Diabetic nephropathy	5	6.0%	17	10.1%	0.280
Diabetic neuropathy	3	3.6%	8	4.8%	0.676
Diabetic retinopathy	11	13.3%	12	7.1%	0.114
CVA	8	9.6%	25	14.9%	0.248
PVD	2	2.4%	10	6.0%	0.213
Metformin	69	83.1%	138	82.1%	0.846
Sulfonylureas	18	21.7%	34	20.2%	0.790
Insulin	34	41.0%	83	49.4%	0.207
DPP4i	31	37.3%	74	44.0%	0.311
Thiazolidinediones	6	7.2%	11	6.5%	0.840
GLP-1 analogues	4	4.8%	9	5.4%	0.856
Alpha-glucosidase inhibitors	0	0.0%	1	0.6%	0.481
ARBs/ACEi	40	48.2%	116	69%	0.001*
Beta-blockers	31	37.3%	57	33.9%	0.593
Diuretics	23	27.7%	89	53.0%	0.000*
Calcium channel blockers	22	26.5%	70	41.7%	0.019*
Lipid-lowering agents	15	50.0%	153	69.2%	0.036*
Antiplatelet agents	44	62.9%	104	72.2%	0.164

↓ Table 2. Comparison of Patients’ Categorial Characteristics According to the Presence of LVDD

Patients’ characteristics

LVDD

P-value

Yes

*P ≤ 0.05. ACEi: angiotensin-converting enzyme inhibitor; ARBs: angiotensin II receptor blockers; CVA: cerebral vascular accident; DPP4i: dipeptidyl peptidase 4 inhibitor; GLP-1: glucagon-like peptide 1; HTN: hypertension; LVDD: left ventricular diastolic dysfunction; PVD: peripheral vascular disease.

Gender

0.534

Male

41.0%

36.9%

Female

59.0%

106

63.1%

HTN

60.2%

143

85.1%

0.000*

Dyslipidemia

77.1%

139

83.2%

0.243

Diabetic nephropathy

6.0%

10.1%

0.280

Diabetic neuropathy

3.6%

4.8%

0.676

Diabetic retinopathy

13.3%

7.1%

0.114

CVA

9.6%

14.9%

0.248

PVD

2.4%

6.0%

0.213

Metformin

83.1%

138

82.1%

0.846

Sulfonylureas

21.7%

20.2%

0.790

Insulin

41.0%

49.4%

0.207

DPP4i

37.3%

44.0%

0.311

Thiazolidinediones

7.2%

6.5%

0.840

GLP-1 analogues

4.8%

5.4%

0.856

Alpha-glucosidase inhibitors

0.0%

0.6%

0.481

ARBs/ACEi

48.2%

116

69%

0.001*

Beta-blockers

37.3%

33.9%

0.593

Diuretics

27.7%

53.0%

0.000*

Calcium channel blockers

26.5%

41.7%

0.019*

Lipid-lowering agents

50.0%

153

69.2%

0.036*

Antiplatelet agents

62.9%

104

72.2%

0.164

↓ **Table 3.** Correlation Between Presence of LVDD and Clinical Parameters
Clinical parameter	Mann-Whitney U test	Z	Effect size (r)	P value
*P ≤ 0.05. BMI: body mass index; DBP: diastolic blood pressure; DM: diabetes mellitus; eGFR: estimated glomerular filtration rate; FBS: fasting blood sugar; HbA1c: glycated hemoglobin; HDL: high-density lipoprotein; LDL: low-density lipoprotein; LVDD: left ventricular diastolic dysfunction; SBP: systolic blood pressure; TG: triglyceride.
Age	3,814.5	-5.84	0.369	0.000*
DM duration	2,270.5	-3.13	0.239	0.002*
Height	6,645.5	-0.6	0.038	0.546
Weight	6,017.5	-1.76	0.111	0.078
BMI	5,336	-2.76	0.175	0.006*
SBP level	4,687.5	-3.93	0.250	0.000*
DBP level	5,987	-1.75	0.111	0.080
FBS	5,824	-2.12	0.134	0.034*
HbA1c level	5,607	-2.39	0.151	0.017*
Total cholesterol	6,590	-0.48	0.030	0.630
HDL	5,988.5	-1.82	0.115	0.069
LDL	5,967.5	-1.51	0.096	0.131
TG	5,973.5	-1.57	0.100	0.116
Creatinine	6,170.5	-1.48	0.093	0.138
eGFR level	4,841	-3.94	0.249	0.000*

↓ Table 3. Correlation Between Presence of LVDD and Clinical Parameters

Clinical parameter

Mann-Whitney U test

Effect size (r)

P value

*P ≤ 0.05. BMI: body mass index; DBP: diastolic blood pressure; DM: diabetes mellitus; eGFR: estimated glomerular filtration rate; FBS: fasting blood sugar; HbA1c: glycated hemoglobin; HDL: high-density lipoprotein; LDL: low-density lipoprotein; LVDD: left ventricular diastolic dysfunction; SBP: systolic blood pressure; TG: triglyceride.

Age

3,814.5

-5.84

0.369

0.000*

DM duration

2,270.5

-3.13

0.239

0.002*

Height

6,645.5

-0.6

0.038

0.546

Weight

6,017.5

-1.76

0.111

0.078

BMI

5,336

-2.76

0.175

0.006*

SBP level

4,687.5

-3.93

0.250

0.000*

DBP level

5,987

-1.75

0.111

0.080

FBS

5,824

-2.12

0.134

0.034*

HbA1c level

5,607

-2.39

0.151

0.017*

Total cholesterol

6,590

-0.48

0.030

0.630

HDL

5,988.5

-1.82

0.115

0.069

LDL

5,967.5

-1.51

0.096

0.131

5,973.5

-1.57

0.100

0.116

Creatinine

6,170.5

-1.48

0.093

0.138

eGFR level

4,841

-3.94

0.249

0.000*

↓ **Table 4.** Multiple Logistic Regression Analysis for the Predictors of LVDD
Predictor factor	B	SE	Exp(B)^a	95% CI for Exp(B)	P value
*P ≤ 0.05. ^aAdjusted for the effect of all other included predictor factors in the analysis. ACEi: angiotensin converting enzyme inhibitor; ARBs: angiotensin II receptor blockers; BMI: body mass index; CI: confidence interval; DM: diabetes mellitus; eGFR: estimated glomerular filtration rate; FBS: fasting blood sugar; HbA1c: glycated hemoglobin; HTN: hypertension; LVDD: left ventricular diastolic dysfunction; SBP: systolic blood pressure.
Age	0.1	0.03	1.1	1.03	1.18	0.003*
DM duration	0.03	0.03	1.03	0.98	1.08	0.244
BMI	0.13	0.04	1.14	1.05	1.23	0.002*
SBP	0.01	0.01	1.01	0.99	1.02	0.49
FBS	-0.01	0.03	0.99	0.93	1.05	0.733
HbA1c	0.06	0.09	1.06	0.89	1.28	0.496
eGFR	0	0.01	1	0.98	1.03	0.967
HTN	0.14	0.61	1.15	0.35	3.79	0.816
ARB/ACEi	-0.35	0.55	0.7	0.24	2.06	0.523
Diuretics	-0.24	0.48	0.79	0.31	2.04	0.626
Calcium channel blocker	0.16	0.51	1.18	0.43	3.22	0.75
Lipid-lowering medications	1.02	0.6	2.77	0.85	9.07	0.091

↓ Table 4. Multiple Logistic Regression Analysis for the Predictors of LVDD

Predictor factor

Exp(B)^a

95% CI for Exp(B)

P value

Lower

Upper

*P ≤ 0.05. ^aAdjusted for the effect of all other included predictor factors in the analysis. ACEi: angiotensin converting enzyme inhibitor; ARBs: angiotensin II receptor blockers; BMI: body mass index; CI: confidence interval; DM: diabetes mellitus; eGFR: estimated glomerular filtration rate; FBS: fasting blood sugar; HbA1c: glycated hemoglobin; HTN: hypertension; LVDD: left ventricular diastolic dysfunction; SBP: systolic blood pressure.

Age

0.1

0.03

1.1

1.03

1.18

0.003*

DM duration

0.03

1.03

0.98

1.08

0.244

BMI

0.13

0.04

1.14

1.05

1.23

0.002*

SBP

0.01

1.01

0.99

1.02

0.49

FBS

-0.01

0.03

0.99

0.93

1.05

0.733

HbA1c

0.06

0.09

1.06

0.89

1.28

0.496

eGFR

0.01

0.98

1.03

0.967

HTN

0.14

0.61

1.15

0.35

3.79

0.816

ARB/ACEi

-0.35

0.55

0.7

0.24

2.06

0.523

Diuretics

-0.24

0.48

0.79

0.31

2.04

0.626

Calcium channel blocker

0.16

0.51

1.18

0.43

3.22

0.75

Lipid-lowering medications

1.02

0.6

2.77

0.85

9.07

0.091