Increased cardiac troponin I concentration in diabetic ketoacidosis

J Pediatr Endocrinol Metab. 2004 Aug;17(8):1077-82. doi: 10.1515/jpem.2004.17.8.1077.

Abstract

Objective: To examine the hypothesis that diabetic ketoacidosis may be associated with some degree of induced injury to heart muscle, related either to acidosis or hyperglycemia.

Methods: Nineteen diabetic patients with acute ketoacidosis and 19 healthy children were enrolled in this study. Cardiac troponin I (cTnI), creatine kinase (CK)-MB and myoglobin levels were analyzed soon after admission and after 24 h. Patients were subdivided into two groups according to blood pH.

Results: At the time of admission, the diabetic patients had significantly higher values than the controls for cTnI (0.193+/-0.008 vs 0.176+/-0.006 ng/dl; p <0.001), CK-MB (24.1+/-2.1 vs 22.7+/-1.2 U/l; p = 0.02), and myoglobin (85.5+/-7.4 vs 52.5 +/-8.3 microg/dl; p <0.001). The diabetic patients also had significantly higher values than the controls for CK-MB (24+/-2.1 vs 22.7+/-1.2 U/l; p = 0.02) and for myoglobin (78.5+/-2.5 vs 52.5+/-8.3 microg/dl; p <0.001) at 24 h. cTnI had normalized in patients at 24 h. All parameters were significantly different between patients with pH > or =7.0 and patients with pH <7.0. In addition, serum cTnI levels correlated negatively with blood pH (r = -0.57, p = 0.026) and HCO3- (r = -0.65, p = 0.008) in the patients with diabetic ketoacidosis on admission.

Conclusion: Our findings suggest that diabetic ketoacidosis, particularly when severe, has a detrimental effect on the myocardium.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Cardiomyopathies / blood*
  • Cardiomyopathies / etiology
  • Child
  • Diabetic Ketoacidosis / blood*
  • Diabetic Ketoacidosis / complications
  • Female
  • Humans
  • Hydrogen-Ion Concentration
  • Hyperglycemia / blood
  • Hyperglycemia / complications
  • Male
  • Myocardium / metabolism*
  • Myoglobin / blood*
  • Reference Values
  • Statistics, Nonparametric
  • Troponin I / blood*

Substances

  • Biomarkers
  • Myoglobin
  • Troponin I