Diabetic cardiomyopathy and subclinical cardiovascular disease - The Multi-Ethnic Study of Atherosclerosis (MESA)

被引:83
|
作者
Bertoni, AG
Goff, DC
D'Agostino, RB
Liu, K
Hundley, WG
Lima, JA
Polak, JF
Saad, MF
Szklo, M
Tracy, RP
Siscovick, DS
机构
[1] Wake Forest Univ Hlth Sci, Dept Publ Hlth Sci, Winston Salem, NC 27157 USA
[2] Northwestern Univ, Dept Prevent Med, Chicago, IL 60611 USA
[3] Johns Hopkins Univ, Dept Med, Baltimore, MD USA
[4] Tufts Univ, New England Med Ctr, Dept Radiol, Boston, MA 02111 USA
[5] SUNY Stony Brook, Hlth Sci Ctr, Sch Med, Dept Prevent Med, Stony Brook, NY 11794 USA
[6] Johns Hopkins Univ, Dept Epidemiol, Baltimore, MD USA
[7] Univ Vermont, Dept Pathol, Colchester, VT USA
[8] Univ Washington, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA
关键词
D O I
10.2337/diacare.29.03.06.dc05-1501
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - Studies have demonstrated increased left ventricular mass (LVM) and diastolic dysfunction among diabetic patients without clinical cardiovascular disease (CVD), but few have assessed the potential contribution of subclinical CVD to ventricular abnormalities in diabetes. We examined whether diabetic cardiomyopathy is associated with subclinical atherosclerosis and if abnormalities are found with impaired fasting glucose (IFG). RESEARCH DESIGN AND METHODS - LVM, end-diastolic volume (EDV), and stroke volume were measured by magnetic resonance imaging (MRI), and atherosclerosis was assessed by coronary artery calcium and carotid intima-media wall thickness in 4,991 participants in the Multi-Ethnic Study of Atherosclerosis, a cohort study of adults aged 45-84 without prior CVD. Multivariable linear regression was used to analyze the association between MRI measures and glucose status. RESULTS - increased LVM was observed in white, black, and Hispanic participants with diabetes but not among Chinese participants. After adjustment for weight, height, CVD risk factors, and subclinical atherosclerosis, ethnicity-specific differences in ventricular parameters were present. Among whites and Chinese with diabetes, LVM was similar to that in normal subjects; EDV and stroke volume were reduced. In blacks with diabetes, EDV and stroke volume were similar to normal, but LVM was increased (+ 5.6 g, P < 0.05). Among Hispanics with and stroke volume were similar to normal, but LVM was increased (+5.5 g, P < 0.05). After adjustment, IFG was associated with a decrease in EDV and stroke Volume in whites and blacks only; however, no significant differences in LVM were observed. CONCLUSIONS - Ethnicity-specific differences in LVM, EDV, and stroke volume are associated with abnormal glucose metabolism and are independent of subclinical CVD.
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收藏
页码:588 / 594
页数:7
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