Background
Methods
Study population
Measurements and definitions
Echocardiography
Statistical analysis
Results
Baseline demographic, metabolic, and echocardiographic characteristics
Variable | All participants (n = 1817) | Not developing type 2 diabetes (n = 1544) | Developing type 2 diabetes (n = 273) |
P value |
---|---|---|---|---|
Age (years) | 53.5 ± 6.7 | 53.1 ± 6.4 | 55.7 ± 7.5 | <0.001 |
Male (%) | 47.9 | 48.1 | 47.3 | 0.844 |
BMI (kg/m2) | 24.5 ± 2.7 | 24.3 ± 2.6 | 25.4 ± 2.8 | <0.001 |
Systolic BP (mmHg) | 110.3 ± 13.5 | 109.4 ± 13.3 | 115.1 ± 13.6 | <0.001 |
Diastolic BP (mmHg) | 74.6 ± 9.5 | 74.3 ± 9.6 | 76.1 ± 9.1 | 0.002 |
Heart rate (bpm) | 65.0 ± 6.9 | 64.9 ± 6.9 | 65.4 ± 6.9 | 0.318 |
Hypertension (%) | 22.1 | 19.7 | 35.9 | <0.001 |
Antihypertensive therapy (%) | 16.8 | 14.5 | 29.7 | <0.001 |
Fasting glucose (mg/dL) | 90.9 ± 8.4 | 89.9 ± 7.8 | 96.3 ± 9.7 | <0.001 |
2-h glucose (mg/dL) | 134.3 ± 30.6 | 129.8 ± 28.4 | 160.0 ± 29.7 | <0.001 |
Fasting insulin (µIU/mL) | 8.70 ± 4.03 | 8.52 ± 3.99 | 9.71 ± 4.12 | <0.001 |
HbA1c (%) | 5.43 ± 0.35 | 5.39 ± 0.33 | 5.65 ± 0.38 | <0.001 |
HOMA-IR | 1.97 ± 0.98 | 1.91 ± 0.95 | 2.33 ± 1.06 | <0.001 |
Family history of diabetes (%) | 17.5 | 16.6 | 22.7 | 0.016 |
Glucose metabolism (%) | <0.001 | |||
NGM | 43.4 | 49.2 | 10.6 | |
Prediabetes | 56.6 | 50.8 | 89.4 | |
Current smoker (%) | 13.5 | 14.3 | 9.2 | 0.021 |
Current alcohol drinker (%) | 50.0 | 50.1 | 49.5 | 0.896 |
Total cholesterol (mg/dL) | 202.5 ± 34.2 | 202.1 ± 34.5 | 204.8 ± 32.9 | 0.217 |
HDL-cholesterol (mg/dL) | 45.5 ± 10.6 | 45.9 ± 10.6 | 43.5 ± 10.5 | 0.001 |
Triglycerides (mg/dL) | 134.6 ± 83.0 | 129.6 ± 79.5 | 162.3 ± 96.1 | <0.001 |
Statin therapy (%) | 2.5 | 1.4 | 3.4 | 0.007 |
hsCRP (mg/L) | 1.39 ± 4.17 | 1.28 ± 3.93 | 2.03 ± 5.31 | 0.006 |
Creatinine (mg/dL) | 0.95 ± 0.15 | 0.95 ± 0.14 | 0.96 ± 0.16 | 0.282 |
Variable | Total (n = 1817) | Not developing type 2 diabetes (n = 1544) | Developing type 2 diabetes (n = 273) |
P value |
---|---|---|---|---|
LA volume index (mL/m2) | 26.2 ± 6.3 | 26.1 ± 6.3 | 26.7 ± 6.4 | 0.181 |
Relative wall thickness | 0.37 ± 0.06 | 0.36 ± 0.06 | 0.39 ± 0.07 | <0.001 |
LV mass (g) | 150 ± 37 | 149 ± 37 | 158 ± 38 | <0.001 |
LV mass index (g/m2) | 87.3 ± 16.6 | 86.7 ± 16.4 | 91.2 ± 17.0 | <0.001 |
LV hypertrophy (%) | 13.9 | 13.1 | 18.7 | 0.017 |
LV ejection fraction (%) | 65.0 ± 4.5 | 65.1 ± 4.5 | 64.7 ± 4.5 | 0.235 |
Mitral inflow velocity | ||||
E, cm/s | 0.68 ± 0.15 | 0.68 ± 0.15 | 0.66 ± 0.15 | 0.039 |
A, cm/s | 0.63 ± 0.17 | 0.62 ± 0.17 | 0.70 ± 0.18 | <0.001 |
E/A ratio | 1.15 ± 0.36 | 1.17 ± 0.37 | 0.99 ± 0.30 | <0.001 |
DT, ms | 195 ± 47 | 195 ± 47 | 200 ± 47 | 0.091 |
Tissue Doppler imaging (TDI) | ||||
TDI Sm velocity (cm/s) | 7.68 ± 1.29 | 7.70 ± 1.29 | 7.47 ± 1.27 | 0.018 |
TDI Em velocity (cm/s) | 7.57 ± 1.83 | 7.67 ± 1.80 | 7.47 ± 1.70 | <0.001 |
E/Em ratio | 9.31 ± 2.62 | 9.19 ± 2.55 | 10.23 ± 3.00 | <0.001 |
LV diastolic dysfunction (%) | 37.5 | 34.6 | 54.2 | <0.001 |
Independent predictors of incident T2D
Variables | Univariate | Multivariatea
| |||
---|---|---|---|---|---|
OR (95% CI) |
P value | OR (95% CI) |
P value |
P valueb
| |
LA volume index (mL/m2) | 1.013 (0.993–1.034) | 0.189 | 1.017 (0.995–1.040) | 0.133 | 0.933 |
LV mass index (g/m2) | 1.016 (1.008–1.024) | <0.001 | 1.009 (1.000–1.018) | 0.040 | 0.283 |
LV hypertrophy (yes vs. no) | 1.526 (1.088–2.141) | 0.014 | 1.198 (0.806–1.780) | 0.371 | 1.000 |
TDI Sm velocity (cm/s) | 0.856 (0.772–0.949) | 0.003 | 0.914 (0.816–1.024) | 0.119 | 0.836 |
TDI Em velocity (cm/s) | 0.742 (0.685–0.804) | <0.001 | 0.867 (0.786–0.957) | 0.004 | 0.031 |
E/Em ratio | 1.147 (1.094–1.201) | <0.001 | 1.076 (1.017–1.137) | 0.010 | 0.071 |
LV diastolic dysfunction (yes vs. no) | 2.239 (1.726–2.905) | <0.001 | 1.617 (1.191–2.196) | 0.002 | 0.014 |
Variables | NGM (n = 788) | Prediabetes (n = 1029) | ||||
---|---|---|---|---|---|---|
OR (95% CI) |
P value |
P valuea
| OR (95% CI) |
P value |
P valuea
| |
LA volume index (mL/m2) | 1.037 (0.982–1.095) | 0.190 | 1.000 | 1.021 (0.993–1.048) | 0.140 | 1.000 |
LV mass index (g/m2) | 0.999 (0.973–1.026) | 0.948 | 1.000 | 1.014 (1.004–1.025) | 0.009 | 0.126 |
LV hypertrophy (yes vs. no) | 0.848 (0.268–2.683) | 0.779 | 1.000 | 1.315 (0.833–2.074) | 0.240 | 1.000 |
TDI Sm velocity (cm/s) | 0.892 (0.633–1.257) | 0.513 | 1.000 | 0.872 (0.764–0.995) | 0.041 | 0.574 |
TDI Em velocity (cm/s) | 0.958 (0.725–1.267) | 0.765 | 1.000 | 0.864 (0.770–0.968) | 0.012 | 0.168 |
E/Em ratio | 1.078 (0.900–1.292) | 0.416 | 1.000 | 1.064 (1.000–1.134) | 0.051 | 0.714 |
LV diastolic dysfunction (yes vs. no) | 1.000 (0.389–2.575) | 0.999 | 1.000 | 1.906 (1.335–2.721) | <0.001 | 0.005 |