Cardiac troponin I concentrations in people presenting with diabetic ketoacidosis

Ann Clin Biochem. 2007 Jul;44(Pt 4):391-3. doi: 10.1258/000456307780945750.

Abstract

Background: Elevated troponin concentrations may be observed in a wide spectrum of medical disorders in people without evidence of overt ischaemic heart disease. The prospective relationship between serum cardiac troponin I (cTnI) and diabetic ketoacidosis (DKA) has not been examined in adults.

Methods: Forty patients (14 male and 26 female) with type 1 diabetes were recruited. cTnI, creatine kinase (CK), cystatin C and beta-hydroxybutyrate were measured on admission and at 24, 48 and 72 h post-admission. Daily electrocardiographs were also performed.

Results: Four out of forty subjects presenting with DKA had an increase in cTnI (median (SD) 0.06 (0.31) microg/L). One of the subjects had multiple possible reasons for the elevated cTnI concentration. However, the other three subjects had no obvious precipitating factors. This cohort underwent echocardiography and thallium-201 scintigraphy, which revealed no abnormalities.

Conclusions: Minor troponin elevations appear to occur in a small number of subjects with type 1 diabetes presenting with DKA. The clinical relevance of this at this stage remains unknown and further large-scale studies are suggested.

MeSH terms

  • 3-Hydroxybutyric Acid / blood
  • Adult
  • Aged
  • Biomarkers / blood
  • Cohort Studies
  • Creatine Kinase / blood
  • Cystatin C
  • Cystatins / blood
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / therapy
  • Diabetic Ketoacidosis / blood*
  • Echocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Treatment Outcome
  • Troponin I / blood*
  • Troponin T / blood

Substances

  • Biomarkers
  • CST3 protein, human
  • Cystatin C
  • Cystatins
  • Troponin I
  • Troponin T
  • Creatine Kinase
  • 3-Hydroxybutyric Acid