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
Authors' conclusion
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.
Study context
- Population
- CARDIA study participants with vs without early-onset T2D or prediabetes, years 0–25matched cohort
- Participants
- 287 vs 565
- Exposure
- Early-onset T2D/prediabetes (pre-D) vs euglycaemia
- T2D/pre-Dn = 287
- Euglycaemian = 565reference
- Outcome
- Associations of cumulative metabolic risk factors (RFs) (AUC) with LVMI, RWT and LV remodelling patterns
- Follow-up
- 20 years
Methodological detailssociodemographic-matched, years 0-25, cumulative burden by AUC of growth curves from quadratic random-effects models
- Sociodemographic-matched
- Years 0-25
- Cumulative burden by AUC of growth curves from quadratic random-effects models
Main finding
As reported in the abstract
Cumulative metabolic RFs (per 1 SD greater AUC) and RWT, LVMI, concentric hypertrophy
- Log(TG) (per 0.48) with relative wall thickness (RWT), T2D/pre-D vs euglycaemia: β 0.21 vs 0.01
- P interaction .02
- High-density lipoprotein cholesterol (HDL-c) (per 13.5 mg/dL) with RWT, T2D/pre-D vs euglycaemia: β −0.2 vs 0.05
- P interaction .03
- Greater AUCs of log(FG) (per 0.17) and log(insulin) (per 0.43) associated with higher RWT in both groups
- β ranges 0.12-0.24
- Greater AUCs of SBP (per 10 mmHg) and DBP (per 7.3 mmHg) associated with higher RWT and left ventricular mass index (LVMI), irrespective of glycaemic status
- β ranges 0.17-0.28
- Cumulative TG and concentric hypertrophy, T2D/pre-D only: OR
- 3.4 (1.8-6.3) (95% CI)
- Cumulative HDL-c and concentric hypertrophy, T2D/pre-D only: OR
- 0.23 (0.09-0.59) (95% CI)
- Cumulative total-c and concentric hypertrophy, T2D/pre-D only: OR
- 1.9 (1.1-3.1) (95% CI)
- Cumulative FG and concentric hypertrophy, T2D/pre-D only: OR
- 2.2 (1.25-3.9) (95% CI)
Observational data: associations, not effects.
Original publication
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. Published 4 June 2024. doi:10.
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