{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:08:37Z","timestamp":1790690917193,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus (T2DM) is closely linked to heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective study of 274 asymptomatic patients with T2DM without clinical heart failure or coronary artery disease used portable noninvasive cardiometry to assess hemodynamic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with albuminuria (n=119) showed significantly lower stroke volume and index of contractility (ICON 29.44 \u00b1 9.48 vs 34.78 \u00b1 10.18, p&amp;lt;0.0001), and higher systemic vascular resistance compared with those without albuminuria (n=155). Albuminuria remained independently associated with reduced ICON after multivariable adjustment that included sex, body mass index, and metabolic parameters. Higher BMI was also strongly associated with lower ICON. Patients with albuminuria also had a higher all-cause medical hospitalization rate (39.5% vs 24.5%) during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings suggest that T2DM patients with albuminuria may represent a high-risk CKM phenotype characterized by subclinical hemodynamic alterations, supporting further investigation of noninvasive approaches for early cardiovascular risk assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1966139","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:37:43Z","timestamp":1790689063000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying a high-risk CKM syndrome phenotype: association of albuminuria with subclinical hemodynamic alterations via portable noninvasive cardiometer"],"prefix":"10.3389","volume":"17","author":[{"given":"Ting-Chun","family":"Chen","sequence":"first","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"Division of Endocrinology and Metabolism, Cheng Ching Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Li","family":"Lin","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Yin","family":"Kuo","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"Department of Surgery, Chung Shan Medical University Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sing-Hua","family":"Tsou","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Chung Shan Medical University Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun-Wen","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Changhua Christian Hospital","place":["Changhua, Taiwan"]},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Ning","family":"Huang","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"Division of Endocrinology and Metabolism, Chung-Shan Medical University Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.118.311371","article-title":"Heart failure in type 2 diabetes mellitus","volume":"124","author":"Kenny","year":"2019","journal-title":"Circ Res"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.034986","article-title":"Incidence of hospitalization for heart failure and case-fatality among 3.25 million people with and without diabetes mellitus","volume":"138","author":"McAllister","year":"2018","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1186\/s12933-024-02358-0","article-title":"Prevalence and incidence of heart failure in type 2 diabetes patients: results from a nationwide prospective cohort-the DIABET-IC study","volume":"23","author":"Gonzalez-Manzanares","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001453","article-title":"2026 AHA\/ACC\/ADA\/ASN guideline for the prevention, detection, evaluation, and management of cardiovascular-kidney-metabolic syndrome: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","author":"Ndumele","year":"2026","journal-title":"Circulation"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000691","article-title":"Type 2 diabetes mellitus and heart failure: A scientific statement from the American Heart Association and the Heart Failure Society of America: This statement does not represent an update of the 2017 ACC\/AHA\/HFSA heart failure guideline update","volume":"140","author":"Dunlay","year":"2019","journal-title":"Circulation"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2020.0282","article-title":"Epidemiology, pathophysiology, diagnosis and treatment of heart failure in diabetes","volume":"45","author":"Park","year":"2021","journal-title":"Diabetes Metab J"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2022.0278","article-title":"Natriuretic peptide testing and heart failure diagnosis in primary care: diagnostic accuracy study","volume":"73","author":"Taylor","year":"2023","journal-title":"Br J Gen Pract"},{"key":"B8","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s12933-017-0506-x","article-title":"Diagnostic approaches for diabetic cardiomyopathy","volume":"16","author":"Lorenzo-Almor\u00f3s","year":"2017","journal-title":"Cardiovasc Diabetol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1186\/s12871-019-0917-1","article-title":"Evaluation of peripheral perfusion index and heart rate variability as early predictors for intradialytic hypotension in critically ill patients","volume":"19","author":"Mostafa","year":"2019","journal-title":"BMC Anesthesiol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-012-9412-7","article-title":"Non-invasive measurement of cardiac output in obese children and adolescents: comparison of electrical cardiometry and transthoracic Doppler echocardiography","volume":"27","author":"Rauch","year":"2013","journal-title":"J Clin Monit Comput"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.4103\/IJCIIS.IJCIIS_87_18","article-title":"Determining pediatric fluid responsiveness by stroke volume variation analysis using ICON\u00ae electrical cardiometry and ultrasonic cardiac output monitor: A cross-sectional study","volume":"10","author":"Kadafi","year":"2020","journal-title":"Int J Crit Illn Inj Sci"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0b013e32834cfebb","article-title":"Comparison of invasive and non-invasive measurements of haemodynamic parameters in patients with advanced heart failure","volume":"12","author":"Sokolski","year":"2011","journal-title":"J Cardiovasc Med (Hagerstown)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-019-00330-y","article-title":"Accuracy and precision of non-invasive cardiac output monitoring by electrical cardiometry: a systematic review and meta-analysis","volume":"34","author":"Sanders","year":"2020","journal-title":"J Clin Monit Comput"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-S002","article-title":"2. Diagnosis and classification of diabetes: Standards of care in diabetes-2024","volume":"47","author":"Committee","year":"2024","journal-title":"Diabetes Care"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2016.82","article-title":"Biomarkers: Albuminuria - a marker of systemic microvascular function","volume":"12","author":"Boor","year":"2016","journal-title":"Nat Rev Nephrol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.030131","article-title":"Albuminuria: An underappreciated risk factor for cardiovascular disease","volume":"13","author":"Barzilay","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v16.i9.106914","article-title":"Albuminuria is independently associated with preclinical left ventricular systolic dysfunction: The TESEO study","volume":"16","author":"Barutta","year":"2025","journal-title":"World J Diabetes"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1007\/BF02344724","article-title":"Stroke volume equation for impedance cardiography","volume":"43","author":"Bernstein","year":"2005","journal-title":"Med Biol Eng Comput"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198610000-00017","article-title":"A new stroke volume equation for thoracic electrical bioimpedance: theory and rationale","volume":"14","author":"Bernstein","year":"1986","journal-title":"Crit Care Med"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7133.2008.00001.x","article-title":"Systolic time ratio by impedance cardiography to distinguish preserved vs impaired left ventricular systolic function in heart failure","volume":"14","author":"Thompson","year":"2008","journal-title":"Congest Heart Fail"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.117.311586","article-title":"Diabetic cardiomyopathy: An update of mechanisms contributing to this clinical entity","volume":"122","author":"Jia","year":"2018","journal-title":"Circ Res"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2019.04.008","article-title":"Impairment of left and right ventricular longitudinal strain in asymptomatic children with type 1 diabetes","volume":"71","author":"Zairi","year":"2019","journal-title":"Indian Heart J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/s12933-018-0756-2","article-title":"Overweight and obesity impair left ventricular systolic function as measured by left ventricular ejection fraction and global longitudinal strain","volume":"17","author":"Blomstrand","year":"2018","journal-title":"Cardiovasc Diabetol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2018.02.012","article-title":"Impact of diabetes and increasing body mass index category on left ventricular systolic and diastolic function","volume":"31","author":"Ng","year":"2018","journal-title":"J Am Soc Echocardiogr"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glaa020","article-title":"Hospitalization rates in older adults with albuminuria: The Cardiovascular Health Study","volume":"75","author":"Barzilay","year":"2020","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"B26","doi-asserted-by":"publisher","first-page":"21327","DOI":"10.1038\/s41598-023-48716-y","article-title":"Effects of canagliflozin on cardiac remodeling and hemodynamic parameters in patients with type 2 diabetes mellitus","volume":"13","author":"Kuo","year":"2023","journal-title":"Sci Rep"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1966139\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:37:44Z","timestamp":1790689064000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1966139\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":26,"alternative-id":["10.3389\/fendo.2026.1966139"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1966139","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"1966139"}}