The relationship between the level of Nt-proBNP and indicators of clinical and metabolic status in comorbid elderly patients with type 2 diabetes mellitus

Aim – to determine the specific features of the use of the semi-quantitative Nt-proBNP immunochromatographic assessment technique for the diagnosis of chronic heart failure (CHF) in comorbid elderly patients with type 2 diabetes mellitus (DM2) in relation to indicators of clinical and metabolic status. Material and methods. The study was performed using a cross-sectional design; 97 clinical and laboratory-instrumental indicators were studied, including the determination of Nt-proBNP by a semi-quantitative method, in a sample of 50 comorbid elderly patients with T2DM; groups were identified according to the threshold value of Nt-proBNP 450 pg/ml; the interrelationships and significance of differences in variables in the groups were analyzed, including the number of average values of biomarkers for achieving the goals of DM2 treatment and the structure of drug therapy. Results. A high prevalence of comorbid pathology (arterial hypertension: 90%, obesity: 74%, dyslipidemia: 72%) and a high proportion of participants’ failure to achieve therapeutic goals, comparable in the Nt-proBNP groups, were revealed; a significant association between the Nt-proBNP group and the previously established stage of CHF (χ2 = 6.4; p = 0.041), a positive correlation with the ratio of transmittal blood flow rates in early and late diastole E/A (r = 0.309; p = 0.003); Indirect evidence has been obtained for the high sensitivity of the semi-quantitative assessment of Nt-proBNP for the diagnosis of early-stage CHF. Conclusion. The majority of comorbid elderly patients with DM2 (72%) have Nt-proBNP levels above the general population threshold of 125 pg/ml and need to verify the diagnosis of CHF. The assessment of the Nt-proBNP test result in T2DM has its own specifics due to polymorbid pathology (obesity and CKD) and the presence of multidirectional “disturbing” factors. When planning a follow-up program for elderly patients with DM2 and hypertension, the indications for Nt-proBNP screening should be taken into account, and if the result is positive, for an in-depth Echocardiography examination.