Left ventricular concentric geometry predicts incident diabetes mellitus independent of established risk factors in the general population: the Copenhagen City Heart Study

Abstract

BackgroundSubtle impairments in left ventricular (LV) function and geometry are common findings in individuals with diabetes. However, whether these impairments precede the development of diabetes mellitus (DM) is not entirely clear.MethodsEchocardiograms from 1710 individuals from the general population free of prevalent diabetes mellitus were analyzed. Left ventricular (LV) concentric geometry was defined as either LV concentric remodeling or LV concentric hypertrophy as directed in contemporary guidelines. The severity of LV concentricity was assessed by relative wall thickness (RWT) calculated as posterior wall thickness (PWT) indexed to left ventricular internal diameter at end diastole (LVIDd) (RWT = 2 * PWT/LVIDd). End-point was incident DM.ResultsMedian follow-up time was 12.6 years (IQR: 12.0–12.8 years). Follow-up was a 100%. A total of 55 participants (3.3%) developed DM during follow-up. At baseline, the prevalence of a concentric LV geometric pattern was significantly higher (41.8% vs 20.3%, p < 0.001) in individuals who developed DM during follow-up. In a final multivariable model adjusting for established DM risk factors including HbA1c, BMI and plasma glucose, LV concentric geometry and RWT remained significantly associated with incident DM (LV concentric geometry: HR 1.99, 95% CI 1.11–3.57, p = 0.021) (RWT: HR 1.41, 95% CI 1.06–1.86, p = 0.017, per 0.1 increase). This association remained despite adjustment for established risk factors for DM.ConclusionAltered LV geometry may precede the development of DM. LV concentric geometry determined by echocardiography and the severity of LV concentricity evaluated as RWT are associated with incident DM in the general population.Electronic supplementary materialThe online version of this article (10.1186/s12933-019-0842-0) contains supplementary material, which is available to authorized users.

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

“…The same study reported that mild, moderate and severe heart failure was associated with 34%, 63%, and 68% increased risk of incident DM, respectively. Findings from other studies also concur with the results of the current study, showing that CVD signi cantly increases the risk of incident DM [6,21].…”

Cardiovascular Disease and Risk of Incident Diabetes Mellitus: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

“…The same study reported that mild, moderate and severe heart failure was associated with 34%, 63%, and 68% increased risk of incident DM, respectively. Findings from other studies also concur with the results of the current study, showing that CVD signi cantly increases the risk of incident DM [6,21].…”

Association of Microalbuminuria with Abnormal Left Ventricular Geometry Patterns in Nigerian Normotensive Type 2 Diabetic Patients

“…Likewise, left ventricular geometry remodeling in the general population can be referred to as a possible risk factor for incident diabetes mellitus, this was suggested by Modin et al in their study on 1710 individuals from the general population free of diabetes mellitus where they found in a multivariable model after adjusting for established DM risk factors such as HbA1c, BMI and plasma glucose, LV concentric geometry and RWT remained significantly associated with incident DM (LV concentric geometry: hazard ratio (HR) 1.99, 95% CI 1.11-3.57, p = 0.021) (RWT: HR 1.41, 95% CI 1.06-1.86, p = 0.017, per 0.1 increase) [25].…”