Cardiovascular disease and risk of incident diabetes mellitus: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Abstract

IntroductionStudies have reported an association between cardiovascular disease (CVD) and risk of diabetes mellitus (DM). The mechanisms underlying this association remain unclear. We examined the association of CVD with incident DM and assessed the roles of weight gain and medication use as mediating factors. MethodsData from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Visit 1 (2008)(2009)(2010)(2011) and Visit 2 (2014-2017) were used to compare incidence of DM among individuals with and without self-reported CVD at Visit 1. A total of 2081 individuals with self-reported CVD were matched to controls free of self-reported CVD at Visit 1 using 1:1 propensity score matching. Covariates included in the propensity model were sociodemographic characteristics, lifestyle factors, comorbid conditions, and study site. The effect of self-reported CVD on incident DM was examined using Generalized Estimating Equation. The mediating effects of weight gain and use of cardiovascular medications were evaluated. ResultsCovariate distributions were similar among individuals with and without self-reported CVD. The incidence of DM among persons with selfreported CVD was 15.6% vs. 12.7% among those without self-reported CVD. Compared to individuals without self-reported CVD, individuals with self-reported CVD had a 28% increased risk for incident DM (OR=1.28, 95%CI= 1.07, 1.52). The association between self-reported CVD and DM was mediated by the use of beta-blockers (proportion mediated=31%), statins (proportion mediated=24%), and diuretics (proportion mediated=8%). We found that weight gain did not explain the observed association. ConclusionsCardiovascular disease was associated with a signi cant increased risk of incident diabetes. The observed association was partially mediated by some medications used to manage CVD.