Cardiac Geometry and Function in Diabetic or Prediabetic Adolescents and Young Adults The Strong Heart Study

被引:43
作者
De Marco, Marina [1 ]
de Simone, Giovanni [1 ,2 ]
Roman, Mary J. [2 ]
Chinali, Marcello [1 ]
Lee, Elisa T. [3 ]
Calhoun, Darren [4 ]
Howard, Barbara V. [4 ]
Devereux, Richard B. [2 ]
机构
[1] Federico II Univ Hosp, Dept Clin & Expt Dis, Naples, Italy
[2] Weill Cornell Med Coll, Div Cardiol, New York, NY USA
[3] Univ Oklahoma, Dept Biostat & Epidemiol, Oklahoma City, OK USA
[4] Medstar Hlth Res Inst, Hyattsville, MD USA
基金
美国国家卫生研究院;
关键词
LEFT-VENTRICULAR MASS; IMPACT; HYPERTENSION; CHILDREN; CHAMBER; OBESITY; DISEASE; VOLUME;
D O I
10.2337/dc11-0191
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
OBJECTIVE-The aim of this study was to evaluate whether diabetes (DM) and impaired fasting glucose (IFG) were associated with early alterations in left ventricular geometry and function in a large population of adolescents and young adults independently of major confounders. RESEARCH DESIGN AND METHODS-We analyzed echocardiographic data of 1,624 14- to 39-year-old participants (mean age 26.6 +/- 7.7 years; 57% female) without prevalent cardiovascular disease from the fourth Strong Heart Study examination; 179 (11%) participants had DM and 299 (18%) had IFG. RESULTS-Participants with DM and IFG were older and more often obese and hypertensive than participants with normal fasting glucose (NFG) (all P < 0.05). After adjustment for age, sex, systolic blood pressure, and body fat, diabetic and IFG participants had higher left ventricular mass index than those with NFG (41.5 +/- 8.7 and 39.6 +/- 9.2 vs. 35.6 +/- 7.8 g/m(2.7)) and reduced stress-corrected midwall shortening (98 +/- 8.6 and 99 +/- 7.5 vs. 101 +/- 8.5%; all P < 0.05). The prevalence of left ventricular hypertrophy was higher in DM (20%) and IFG (17%) than in NFG participants (12%; P < 0.05). Compared with the other groups, DM was also associated with higher prevalence of inappropriate left ventricular mass, concentric geometry, and more diastolic abnormalities independently of covariates (all P < 0.05). CONCLUSIONS-In a population of adolescents and young adults, DM is independently associated with early unfavorable cardiovascular phenotype characterized by increased left ventricular mass, concentric geometry, and early preclinical systolic and diastolic dysfunction; early cardiovascular alterations are also present in participants with prediabetes.
引用
收藏
页码:2300 / 2305
页数:6
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