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Reduction in myocardial strain is evident in adolescents and young adults with obesity and type 2 diabetes
Author(s) -
Haley Jessica E,
Zhiqian Gao,
Philip Khoury R,
Nicolas Madsen L,
Thomas Kimball R,
Lawrence Dolan M,
Elaine Urbina M
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12961
Subject(s) - medicine , subclinical infection , obesity , anthropometry , type 2 diabetes , diabetes mellitus , cardiology , heart failure , endocrinology , type 2 diabetes mellitus , metabolic syndrome , blood pressure
Aims/hypothesis Heart failure is a complication of type 2 diabetes (T2DM). Echocardiography can identify subclinical systolic dysfunction in adults with T2DM. We hypothesized that reduced systolic strain was present in youth with T2DM. Methods Global longitudinal strain (GLS) was measured in 151 subjects with T2DM matched to lean (L = 146), and obese (O = 162) subjects (23.0 ± 4.0 years, 35% male, 63% African American). Anthropometrics, BP, HR, labs, and echocardiograms were obtained. ANOVA was performed to compare differences among groups, and ANCOVA to determine if T2DM remained an independent predictor after corrections. Results BP, lipid levels, and metabolic control worsened and GLS was reduced from L to O to T2DM. BMI was lower in L than O or T2DM. Global longitudinal strain rate (GLSR) was lower and LVM/ht 2.7 was higher in O and T2DM as compared to L (all P ≤ .05). Presence of T2DM was an independent determinant of GLS and GLSR adjusted for most CV risk factors, but lost significance when BMI was added to the model. GLS = −21.6‐age*0.088 ‐ male*1.8 + 0.12*BMI + 0.045*DBP + 0.058*HR ‐ 0.023*HDL (R 2 = 0.38, P ≤ .0001); GLSR = −1.20‐male*0.093 + WHR*0.48 + DBP*0.0029 (R 2 = 0.23, P ≤ .0001). Conclusion Both adiposity and T2DM have a deleterious effect on systolic cardiac function. Treatment of obesity in youth is necessary for prevention of future heart failure.