Subclinical left ventricular diastolic dysfunction and incident type 2 diabetes risk: the Korean Genome and Epidemiology Study

Cardiovascular Diabetology

Original Investigation

Hong-Euy Lim¹  Kwang Kon Koh²  Ki-Chul Sung³  Sang Yup Lim⁴  Jin-Seok Kim⁴  Sunwon Kim⁴  Seong Hwan Kim⁵  Goo-Yeong Cho⁶  Jang-Young Kim⁷  Jung Bok Lee⁸  Juri Park⁹  Inkyung Baik^1,10  Seung Ku Lee^1,11  Chol Shin^1,11 

[1] Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea;Department of Cardiology, Gachon University Gil Medical Center, Incheon, South Korea;Department of Cardiology, Kangbuk Samsung Hospital, Seoul, South Korea;Department of Cardiology, Korea University Ansan Hospital, Ansan, South Korea;Department of Cardiology, Korea University Ansan Hospital, Ansan, South Korea;Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, 15355, Ansan, Gyeonggi-do, South Korea;Department of Cardiology, Seoul National University Bundang Hospital, Seongnam, South Korea;Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, South Korea;Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, South Korea;Department of Endocrinology, Hallym University Kangdong Sacred Heart Hospital, Seoul, South Korea;Department of Foods and Nutrition, Kookmin University, Seoul, South Korea;Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, South Korea;

关键词: Left ventricle;    Diastolic dysfunction;    Tissue Doppler echocardiography;    Type 2 diabetes;    Cohort;   

DOI  :  10.1186/s12933-017-0519-5

 received in 2016-10-28, accepted in 2017-03-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSubclinical left ventricular (LV) diastolic dysfunction in type 2 diabetes (T2D) is a common finding and represents an early sign of diabetic cardiomyopathy. However, the relationship between LV diastolic dysfunction and the incident T2D has not been previously studied.MethodsA total of 1817 non-diabetic participants (mean age, 54 years; 48% men) from the Korean Genome and Epidemiology Study who were free of cardiovascular disease were studied. LV structure and function were assessed by conventional echocardiography and tissue Doppler imaging. Subclinical LV diastolic dysfunction was defined using age-specific cutoff limits for early diastolic (Em) velocity, mitral E/Em ratio, and left atrial volume index.ResultsDuring the 6-year follow-up period, 273 participants (15%) developed T2D. Participants with incident T2D had greater LV mass index (86.7 ± 16.4 vs. 91.2 ± 17.0 g/m2), worse diastolic function, reflected by lower Em velocity (7.67 ± 1.80 vs. 7.47 ± 1.70) and higher E/Em ratio (9.19 ± 2.55 vs. 10.23 ± 3.00), and higher prevalence of LV diastolic dysfunction (34.6 vs. 54.2%), compared with those who did not develop T2D (all P < 0.001). In a multivariate logistic regression model, lower Em velocity (odd ratio [OR], 0.867; 95% confidence interval [CI] 0.786–0.957) and the presence of LV diastolic dysfunction (OR, 1.617; 95% CI 1.191–2.196) were associated with the development of T2D, after adjusting for potential confounding factors.ConclusionsIn a community-based cohort, the presence of subclinical LV diastolic dysfunction was a predictor of the progression to T2D. These data suggest that the echocardiographic assessment of LV diastolic function may be helpful in identifying non-diabetic subjects at risk of incident T2D.

【 授权许可】

CC BY   
© The Author(s) 2017