AIM  To investigate the relationship between fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), C-peptide levels at admission and cardiac functions in patients with diabetes and non-diabetic chronic heart failure (CHF).

  METHODS  Two hundred and thirty-five CHF patients with or without diabetes were selected. According to the order of clinical diagnosis and whether they were accompanied by diabetes, the patients were divided into diabetic group (92 cases) and non-diabetic group (143 cases). One hundred cases of healthy subjects were selected at the same time and served as control group. Respectively compared were the general data of the three groups, the NYHA classification and left ventricular ejection fraction (LVEF) of diabetic group and non-diabetic group, and the levels of FPG, HbA1c and C peptide in CHF patients with different NYHA classifications. Pearson correlation and multiple linear regression analysis were used to analyze the relationship between clinical parameters and LVEF in CHF patients.

  RESULTS  There were no statistically significant differences between the three groups in gender, age and distribution, smoking, history of hypertension, diastolic blood pressure, TBIL, ALT, creatinine, TG, TC, HDL-C, LDL-C and WBC. The comparison of BMI, systolic blood pressure, FPG, HbA1c and C peptide in the three groups showed statistically significant differences (P<0.05). The results of the rank sum test showed that the overall NYHA heart function classification in diabetes group was significantly higher than that in non-diabetic group, and the difference was statistically significant (P<0.01). LVEF level in diabetic group was significantly lower than that in non-diabetic group. There were significant differences in the levels of FPG, HbA1c and C-peptide in all CHF patients, diabetic groups and non-diabetic groups with different NYHA grades (NYHA Ⅱ<NYHA Ⅲ<NYHA Ⅳ) and the difference was statistically significant (P<0.01). Multiple linear regression analysis showed that for diabetes group, adjusting BMI, systolic blood pressure, diastolic blood pressure, creatinine, TC, LDL-C, WBC suggested that FPG, HbA1c, C peptide and LVEF were negatively correlated. For non-diabetic group, adjusting BMI, systolic blood pressure, creatinine, TC, LDL-C, WBC suggested that FPG, HbA1c, C peptide were negatively correlated with LVEF (P<0.05).

  CONCLUSION  Diabetic and non-diabetic CHF patients have increased FPG, HbA1c and C peptide levels, and FPG, HbA1c and C peptide may be associated with the severity of heart failure.