Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study.
Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study.
- 2017
Available online through MWHC library: 2002 - present
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. 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. 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.
English
1475-2840
10.1186/s12933-017-0542-6 [doi] 10.1186/s12933-017-0542-6 [pii] PMC5427627 [pmc]
*Diabetes Mellitus, Type 2/ep [Epidemiology]
*Diabetic Nephropathies/ep [Epidemiology]
*Hypertrophy, Left Ventricular/ep [Epidemiology]
Adiposity
Adult
Albuminuria/di [Diagnosis]
Albuminuria/ep [Epidemiology]
Albuminuria/ur [Urine]
Biomarkers/bl [Blood]
Biomarkers/ur [Urine]
Blood Glucose/me [Metabolism]
Chi-Square Distribution
Creatinine/ur [Urine]
Diabetes Mellitus, Type 2/bl [Blood]
Diabetes Mellitus, Type 2/di [Diagnosis]
Diabetes Mellitus, Type 2/pp [Physiopathology]
Diabetic Nephropathies/di [Diagnosis]
Diabetic Nephropathies/pp [Physiopathology]
Diabetic Nephropathies/ur [Urine]
Disease Progression
Echocardiography, Doppler
Female
Heart Atria/dg [Diagnostic Imaging]
Heart Atria/pp [Physiopathology]
Humans
Hypertrophy, Left Ventricular/dg [Diagnostic Imaging]
Hypertrophy, Left Ventricular/pp [Physiopathology]
Incidence
Indians, North American
Inflammation Mediators/bl [Blood]
Logistic Models
Male
Middle Aged
Multivariate Analysis
Obesity/di [Diagnosis]
Obesity/ep [Epidemiology]
Odds Ratio
Prevalence
Prognosis
Risk Factors
Time Factors
United States/ep [Epidemiology]
MedStar Health Research Institute
Journal Article
Available online through MWHC library: 2002 - present
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. 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. 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.
English
1475-2840
10.1186/s12933-017-0542-6 [doi] 10.1186/s12933-017-0542-6 [pii] PMC5427627 [pmc]
*Diabetes Mellitus, Type 2/ep [Epidemiology]
*Diabetic Nephropathies/ep [Epidemiology]
*Hypertrophy, Left Ventricular/ep [Epidemiology]
Adiposity
Adult
Albuminuria/di [Diagnosis]
Albuminuria/ep [Epidemiology]
Albuminuria/ur [Urine]
Biomarkers/bl [Blood]
Biomarkers/ur [Urine]
Blood Glucose/me [Metabolism]
Chi-Square Distribution
Creatinine/ur [Urine]
Diabetes Mellitus, Type 2/bl [Blood]
Diabetes Mellitus, Type 2/di [Diagnosis]
Diabetes Mellitus, Type 2/pp [Physiopathology]
Diabetic Nephropathies/di [Diagnosis]
Diabetic Nephropathies/pp [Physiopathology]
Diabetic Nephropathies/ur [Urine]
Disease Progression
Echocardiography, Doppler
Female
Heart Atria/dg [Diagnostic Imaging]
Heart Atria/pp [Physiopathology]
Humans
Hypertrophy, Left Ventricular/dg [Diagnostic Imaging]
Hypertrophy, Left Ventricular/pp [Physiopathology]
Incidence
Indians, North American
Inflammation Mediators/bl [Blood]
Logistic Models
Male
Middle Aged
Multivariate Analysis
Obesity/di [Diagnosis]
Obesity/ep [Epidemiology]
Odds Ratio
Prevalence
Prognosis
Risk Factors
Time Factors
United States/ep [Epidemiology]
MedStar Health Research Institute
Journal Article