Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study
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 t...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-05-01
|
| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12933-017-0542-6 |
| _version_ | 1811295955315589120 |
|---|---|
| author | Giovanni de Simone Wenyu Wang Lyle G. Best Fawn Yeh Raffaele Izzo Costantino Mancusi Mary J. Roman Elisa T. Lee Barbara V. Howard Richard B. Devereux |
| author_facet | Giovanni de Simone Wenyu Wang Lyle G. Best Fawn Yeh Raffaele Izzo Costantino Mancusi Mary J. Roman Elisa T. Lee Barbara V. Howard Richard B. Devereux |
| author_sort | Giovanni de Simone |
| collection | DOAJ |
| description | 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 |
| first_indexed | 2024-04-13T05:41:14Z |
| format | Article |
| id | doaj.art-8cbda2f5f0c345a8838558cde32cc582 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-04-13T05:41:14Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-8cbda2f5f0c345a8838558cde32cc5822022-12-22T03:00:05ZengBMCCardiovascular Diabetology1475-28402017-05-011611910.1186/s12933-017-0542-6Target organ damage and incident type 2 diabetes mellitus: the Strong Heart StudyGiovanni de Simone0Wenyu Wang1Lyle G. Best2Fawn Yeh3Raffaele Izzo4Costantino Mancusi5Mary J. Roman6Elisa T. Lee7Barbara V. Howard8Richard B. Devereux9Hypertension Research Center and Department of Translational Medical Sciences, Federico II University HospitalCenter for American Indian Health Research, College of Public Health, University of OklahomaEpidemiology Department, Missouri Breaks Industries Research IncCenter for American Indian Health Research, College of Public Health, University of OklahomaHypertension Research Center and Department of Translational Medical Sciences, Federico II University HospitalHypertension Research Center and Department of Translational Medical Sciences, Federico II University HospitalWeill Cornell MedicineCenter for American Indian Health Research, College of Public Health, University of OklahomaMedStar Health Research InstituteWeill Cornell MedicineAbstract 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 1988http://link.springer.com/article/10.1186/s12933-017-0542-6Arterial hypertensionLeft ventricular hypertrophyLeft atrial dilatationTarget organ damageBody compositionInflammation |
| spellingShingle | Giovanni de Simone Wenyu Wang Lyle G. Best Fawn Yeh Raffaele Izzo Costantino Mancusi Mary J. Roman Elisa T. Lee Barbara V. Howard Richard B. Devereux Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study Cardiovascular Diabetology Arterial hypertension Left ventricular hypertrophy Left atrial dilatation Target organ damage Body composition Inflammation |
| title | Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study |
| title_full | Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study |
| title_fullStr | Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study |
| title_full_unstemmed | Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study |
| title_short | Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study |
| title_sort | target organ damage and incident type 2 diabetes mellitus the strong heart study |
| topic | Arterial hypertension Left ventricular hypertrophy Left atrial dilatation Target organ damage Body composition Inflammation |
| url | http://link.springer.com/article/10.1186/s12933-017-0542-6 |
| work_keys_str_mv | AT giovannidesimone targetorgandamageandincidenttype2diabetesmellitusthestrongheartstudy AT wenyuwang targetorgandamageandincidenttype2diabetesmellitusthestrongheartstudy AT lylegbest targetorgandamageandincidenttype2diabetesmellitusthestrongheartstudy AT fawnyeh targetorgandamageandincidenttype2diabetesmellitusthestrongheartstudy AT raffaeleizzo targetorgandamageandincidenttype2diabetesmellitusthestrongheartstudy AT costantinomancusi targetorgandamageandincidenttype2diabetesmellitusthestrongheartstudy AT maryjroman targetorgandamageandincidenttype2diabetesmellitusthestrongheartstudy AT elisatlee targetorgandamageandincidenttype2diabetesmellitusthestrongheartstudy AT barbaravhoward targetorgandamageandincidenttype2diabetesmellitusthestrongheartstudy AT richardbdevereux targetorgandamageandincidenttype2diabetesmellitusthestrongheartstudy |