Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study.
Cardiovasc Diabetol
; 16(1): 64, 2017 05 12.
Article
in En
| MEDLINE
| ID: mdl-28499385
ABSTRACT
BACKGROUND:
Recent analyses in a registry of hypertensive patients suggested that preceding left ventricular (LV) hypertrophy (LVH) and/or carotid atherosclerosis are associated with incident type 2 diabetes, independent of confounders. We assess the relation between prevalent cardio-renal target organ damage (TOD) and subsequent incident type 2 diabetes in a population-based study with high prevalence of obesity.METHODS:
We selected 2887 non-diabetic participants from two cohorts of the Strong Heart Study (SHS). Clinical exam, laboratory tests and echocardiograms were performed. Adjudicated TODs were LVH, left atrium (LA) dilatation, and high urine albumin/creatinine ratio (UACR). Multivariable logistic regression models were used to identify variables responsible for the association between initial TODs and incident diabetes at 4-year follow-up (FU).RESULTS:
After 4 years, 297 new cases of diabetes (10%) were identified, 216 of whom exhibited baseline impaired fasting glucose (IFG, 73%, p < 0.0001). Participants developing type 2 diabetes exhibited higher inflammatory markers, fat-free mass and adipose mass and higher prevalence of initial LVH and LA dilatation than those without (both p < 0.04). In multivariable logistic regression, controlling for age, sex, family relatedness, presence of arterial hypertension and IFG, all three indicators of TOD predicted incident diabetes (all p < 0.01). However, the effects of TOD was offset when body fat and inflammatory markers were introduced into the model.CONCLUSIONS:
In this population-based study with high prevalence of obesity, TOD precedes clinical appearance of type 2 diabetes and is related to the preceding metabolic status, body composition and inflammatory status. Trial registration Trial registration number NCT00005134, Name of registry Strong Heart Study, URL of registry https//clinicaltrials.gov/ct2/show/NCT00005134, Date of registration May 25, 2000, Date of enrolment of the first participant to the trial September 1988.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hypertrophy, Left Ventricular
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Diabetes Mellitus, Type 2
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Diabetic Nephropathies
Type of study:
Diagnostic_studies
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Etiology_studies
/
Incidence_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Country/Region as subject:
America do norte
Language:
En
Journal:
Cardiovasc Diabetol
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
ENDOCRINOLOGIA
Year:
2017
Type:
Article
Affiliation country:
Italy