Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study.
Target organ damage and incident type 2 diabetes mellitus: the Strong Heart Study.
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DOI：
10.1186/s12933-017-0542-6
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发表时间：
2017-05-12
影响因子：
9.3
通讯作者：
Devereux RB
中科院分区：
文献类型：
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作者：
de Simone G;Wang W;Best LG;Yeh F;Izzo R;Mancusi C;Roman MJ;Lee ET;Howard BV;Devereux RB
最近对高血压患者登记的分析表明，先前的左心室（LV）肥大（LVH）和/或颈动脉粥样硬化与2型糖尿病的发生有关，与混杂因素无关。我们在一项以人群为基础的研究中评估了肥胖高发人群中普遍心肾靶器官损害（TOD）与随后发生的2型糖尿病之间的关系。我们选择了2887非糖尿病参与者从两个队列的强大的心脏研究（SHS）。进行临床检查、实验室检查和超声心动图。裁定的TOD为LVH、左心房（LA）扩张和高尿白蛋白/肌酐比值（UACR）。多变量逻辑回归模型用于确定初始TOD与4年随访（FU）时糖尿病事件之间相关性的变量。4年后，确定了297例新发糖尿病病例（10%），其中216例基线空腹血糖受损（IFG，73%，p < 0.0001）。与未患2型糖尿病的患者相比，患2型糖尿病的患者表现出更高的炎症标志物、无脂肪质量和脂肪质量以及更高的初始LVH和LA扩张患病率（均p < 0.04）。在多变量logistic回归分析中，控制年龄、性别、家族关系、动脉高血压和IFG的存在，所有三个TOD指标预测糖尿病事件（所有p < 0.01）。然而，当将体脂和炎症标记物引入模型中时，TOD的影响被抵消。在这项基于人群的研究中，肥胖患病率较高，TOD先于2型糖尿病的临床表现，并与之前的代谢状态、身体成分和炎症状态相关。 试验登记试验登记编号：NCT 00005134，登记名称：Strong Heart Study，登记网址：https：//clinicaltrials.gov/ct2/show/NCT 00005134，登记日期：2000年5月25日，首例受试者入组试验日期：1988年9月
Recent analyses in a registry of hypertensive patients suggested that preceding left ventricular (LV) hypertrophy (LVH) and/or carotid atherosclerosis are associated with incident type 2 diabetes, independent of confounders. We assess the relation between prevalent cardio-renal target organ damage (TOD) and subsequent incident type 2 diabetes in a population-based study with high prevalence of obesity. We selected 2887 non-diabetic participants from two cohorts of the Strong Heart Study (SHS). Clinical exam, laboratory tests and echocardiograms were performed. Adjudicated TODs were LVH, left atrium (LA) dilatation, and high urine albumin/creatinine ratio (UACR). Multivariable logistic regression models were used to identify variables responsible for the association between initial TODs and incident diabetes at 4-year follow-up (FU). After 4 years, 297 new cases of diabetes (10%) were identified, 216 of whom exhibited baseline impaired fasting glucose (IFG, 73%, p < 0.0001). Participants developing type 2 diabetes exhibited higher inflammatory markers, fat-free mass and adipose mass and higher prevalence of initial LVH and LA dilatation than those without (both p < 0.04). In multivariable logistic regression, controlling for age, sex, family relatedness, presence of arterial hypertension and IFG, all three indicators of TOD predicted incident diabetes (all p < 0.01). However, the effects of TOD was offset when body fat and inflammatory markers were introduced into the model. In this population-based study with high prevalence of obesity, TOD precedes clinical appearance of type 2 diabetes and is related to the preceding metabolic status, body composition and inflammatory status. Trial registration Trial registration number: NCT00005134, Name of registry: Strong Heart Study, URL of registry: https://clinicaltrials.gov/ct2/show/NCT00005134, Date of registration: May 25, 2000, Date of enrolment of the first participant to the trial: September 1988
DOI：
10.1016/j.numecd.2011.02.004
发表时间：
2013-01
期刊：
Nutrition, metabolism, and cardiovascular diseases : NMCD
影响因子：
--
作者：
de Simone G;Arnett DK;Chinali M;De Marco M;Rao DC;Kraja AT;Hunt SC;Devereux RB
通讯作者：
Devereux RB