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J Pediatr Endocrinol Metab. 2004 Aug;17(8):1077-82.

Increased cardiac troponin I concentration in diabetic ketoacidosis.

Author information

1
Department of Pediatrics, Selcuk University, Faculty of Medicine, Konya, Turkey. meatabek@hotmail.com

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.

PMID:
15379418
DOI:
10.1515/jpem.2004.17.8.1077
[Indexed for MEDLINE]

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