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Diabetes, prediabetes in young adults linked with cardiac dysfunction later in life
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Among adults aged 30 years and younger, the durations of both diabetes and prediabetes were linked with cardiac dysfunction and subclinical atherosclerosis later in life, according to findings published in Diabetes Care.
“Adults who develop diabetes or prediabetes at a younger age will be exposed to a longer duration of the condition over the course of their lifetime,” Jared P. Reis, PhD, FAHA, of the National Heart, Lung and Blood Institute, and colleagues wrote. “In addition to the significant clinical and public health-related implications of a longer duration of diabetes and prediabetes in the population, not accounting for these conditions may underestimate risk for CVD, for example, since those with a longer duration are likely to have a longer exposure to chronic hyperglycemia.”
The researchers estimated the durations of diabetes and prediabetes among patients who participated in the Coronary Artery Risk Development in Young Adults (CARDIA) study (n = 3,628). All patients were either white or black, and were aged 18 to 30 years when the study began in 1985 and 1986. Reis and colleagues drew their estimates from examinations conducted at 7, 10, 15, 20 and 25 years after baseline. The researchers measured left ventricular structure and function using echocardiogram at 25 years and coronary artery calcified plaque via CT after 15, 20 and 25 years.
Overall, 12.7% of patients developed diabetes, and more than half (53.8%) developed prediabetes, the researchers reported. Mean age at diagnosis was 42.4 years for diabetes and 39.4 years for prediabetes, and mean duration of disease was 10.7 years for diabetes and 9.5 years for prediabetes.
According to fully adjusted models, for each 5-year duration of diabetes and prediabetes, the adjusted HR for coronary artery calcified plaque rose by 1.15 (95% CI, 1.06-1.25) and 1.07 (95% CI, 1.01-1.13) times, respectively, Reis and colleagues wrote.
The durations of prediabetes and diabetes were both associated with poorer subclinical systolic function (P < .001 for both) and early diastolic relaxation (P = .004 for diabetes; P = .002 for prediabetes), the researchers reported, and diabetes duration was associated with higher levels of diastolic filling pressure (P = .001).
“These data emphasize the importance of early identification and management of those at risk for diabetes and prediabetes in order to limit exposure to the adverse cardiovascular effects of a longer duration of these conditions,” the researchers wrote. – by Andy Polhamus
Disclosures: The authors report no relevant financial disclosures.
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