Cumulative effect of metabolic risk factors on left ventricular geometry in those with versus without early-onset type 2 diabetes or prediabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) study.

Pubmed ID: 38837542

Pubmed Central ID: PMC11639587

Journal: Diabetes, obesity & metabolism

Publication Date: Aug. 1, 2024

MeSH Terms: Humans, Male, Adult, Female, Risk Factors, Adolescent, Body Mass Index, Young Adult, Age of Onset, Diabetes Mellitus, Type 2, Blood Glucose, Coronary Artery Disease, Triglycerides, Hypertrophy, Left Ventricular, Prediabetic State, Heart Ventricles, Ventricular Remodeling

Grants: P30 DK079626, 75N92021D00006, 7-23-JDFWH-10, 75N92020D00005, 75N99023D00006, 75N99023D00005, 75N98023D00003, K12 AR084224, 75N92020D00003, 75N96023D00004, 75N92022D00004, 75N92020D00004, 75N92022D00003, 75N92024D00005, 75N90023D00003, 75N92020D00002, 75N92021D00002, 75N96023D00005, 75N92021D00005, 75N92022D00002, P20 GM152305, 75N94023D00003, 75N90023D00005, 1P20GM152305, 75N92021D00003, 75N92022D00005, 75N92020D00006, 75N97023D00003, 75N96023D00002, 75N99023D00003, 75N92021D00004, 75N96023D00003, 75N93023D00005

Authors: Fonseca VA, Li S, Bae S, Yoshida Y, Zu Y, Fan B, Yoshida T, Harville E, Zhang T, Shikany J

Cite As: Yoshida Y, Zu Y, Fan B, Li S, Yoshida T, Harville E, Zhang T, Bae S, Shikany J, Fonseca VA. Cumulative effect of metabolic risk factors on left ventricular geometry in those with versus without early-onset type 2 diabetes or prediabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) study. Diabetes Obes Metab 2024 Aug;26(8):3392-3402. Epub 2024 Jun 4.

Studies:

Abstract

AIM: To investigate metabolic risk factors (RFs) that accumulated over 20 years related to left ventricular mass index (LVMI), relative wall thickness (RWT) and LV remodelling patterns in participants with versus without early-onset type 2 diabetes (T2D) or prediabetes (pre-D). METHODS: A total of 287 early-onset T2D/pre-D individuals versus 565 sociodemographic-matched euglycaemic individuals were selected from the Coronary Artery Risk Development in Young Adults (CARDIA) study, years 0-25. We used the area under the growth curve (AUC) derived from quadratic random-effects models of four or more repeated measures of RFs (fasting glucose [FG], insulin, triglycerides [TG], low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-c), total cholesterol (total-c), blood pressure and body mass index) to estimate the cumulative burden, and their associations with LV outcomes. RESULTS: One standard deviation greater AUC of log (TG) (per 0.48) and HDL-c (per 13.5 mg/dL) were associated with RWT (β 0.21 and -0.2) in the early-onset T2D/pre-D group, but not in the euglycaemia group (β 0.01 and 0.05, P interactions .02 and .03). In both the early-onset T2D/pre-D and euglycaemia groups, greater AUCs of log (FG) (per 0.17) and log (insulin) (per 0.43) were associated with higher RWT (β ranges 0.12-0.24). Greater AUCs of systolic blood pressure (per 10 mmHg) and diastolic blood pressure (per 7.3 mmHg) were associated with higher RWT and LVMI, irrespective of glycaemic status (β ranges 0.17-0.28). Cumulative TG (odds ratio 3.4, 95% confidence interval: 1.8-6.3), HDL-c (0.23, 0.09-0.59), total-c (1.9, 1.1-3.1) and FG (2.2, 1.25-3.9) were statistically associated with concentric hypertrophy in the T2D/pre-D group only. CONCLUSIONS: Sustained hyperglycaemia and hyperinsulinaemia are associated with RWT, and those individuals with early T2D/pre-D are potentially at greater risk because of their higher levels of glucose and insulin. Dyslipidaemia was associated with LV structural abnormalities in those individuals with early-onset T2D/pre-D.