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

Juri Park, Jin-Seok Kim, Seong Hwan Kim, Sunwon Kim, Sang Yeob Lim, Hong Euy Lim, Goo Yeong Cho, Ki Chul Sung, Jang Young Kim, Inkyung Baik, Kwang Kon Koh, Jung Bok Lee, Seung Ku Lee, Chol Shin

Research output: Contribution to journalArticle

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Abstract

Background: Subclinical 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. Methods: A 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. Results: During 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. Conclusions: In 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.

Original languageEnglish
Article number36
JournalCardiovascular Diabetology
Volume16
Issue number1
DOIs
Publication statusPublished - 2017 Mar 14

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Left Ventricular Dysfunction
Type 2 Diabetes Mellitus
Epidemiology
Genome
Left Ventricular Function
Logistic Models
Odds Ratio
Diabetic Cardiomyopathies
Confidence Intervals
Doppler Echocardiography
Cardiovascular Diseases

Keywords

  • Cohort
  • Diastolic dysfunction
  • Left ventricle
  • Tissue Doppler echocardiography
  • Type 2 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

Cite this

Subclinical left ventricular diastolic dysfunction and incident type 2 diabetes risk : The Korean Genome and Epidemiology Study. / Park, Juri; Kim, Jin-Seok; Kim, Seong Hwan; Kim, Sunwon; Lim, Sang Yeob; Lim, Hong Euy; Cho, Goo Yeong; Sung, Ki Chul; Kim, Jang Young; Baik, Inkyung; Koh, Kwang Kon; Lee, Jung Bok; Lee, Seung Ku; Shin, Chol.

In: Cardiovascular Diabetology, Vol. 16, No. 1, 36, 14.03.2017.

Research output: Contribution to journalArticle

Park, Juri ; Kim, Jin-Seok ; Kim, Seong Hwan ; Kim, Sunwon ; Lim, Sang Yeob ; Lim, Hong Euy ; Cho, Goo Yeong ; Sung, Ki Chul ; Kim, Jang Young ; Baik, Inkyung ; Koh, Kwang Kon ; Lee, Jung Bok ; Lee, Seung Ku ; Shin, Chol. / Subclinical left ventricular diastolic dysfunction and incident type 2 diabetes risk : The Korean Genome and Epidemiology Study. In: Cardiovascular Diabetology. 2017 ; Vol. 16, No. 1.
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abstract = "Background: Subclinical 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. Methods: A 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. Results: During 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. Conclusions: In 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.",
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T2 - The Korean Genome and Epidemiology Study

AU - Park, Juri

AU - Kim, Jin-Seok

AU - Kim, Seong Hwan

AU - Kim, Sunwon

AU - Lim, Sang Yeob

AU - Lim, Hong Euy

AU - Cho, Goo Yeong

AU - Sung, Ki Chul

AU - Kim, Jang Young

AU - Baik, Inkyung

AU - Koh, Kwang Kon

AU - Lee, Jung Bok

AU - Lee, Seung Ku

AU - Shin, Chol

PY - 2017/3/14

Y1 - 2017/3/14

N2 - Background: Subclinical 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. Methods: A 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. Results: During 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. Conclusions: In 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.

AB - Background: Subclinical 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. Methods: A 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. Results: During 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. Conclusions: In 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.

KW - Cohort

KW - Diastolic dysfunction

KW - Left ventricle

KW - Tissue Doppler echocardiography

KW - Type 2 diabetes

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