Abstract 3638: Abnormalities of Left Ventricular Geometry in Youth with Type 2 Diabetes: A greater effect of obesity than fasting glucose

Abstract

Background: Type 2 diabetes (T2), previously a disease of adult onset, is increasing in prevalence amongst children and young adults. Yet the presence of cardiovascular risks, such as left ventricular hypertrophy (LVH) are largely unknown in this population. Purpose: To determine the frequencies of abnormal left ventricular (LV) mass and geometry in young people with T2. Methods: LV mass (LVM) was assessed by echo, indexed to height in meters 2.7, and compared to healthy Obese (O) and Lean (L) controls of similar age, gender matched, non-diabetics. Statistical analysis was performed with non-parametric tests. Data are presented as mean and standard deviations. Results: A total of 98 T2 (ages 11–23 yrs, 19 ± 4 yrs; 64% female, 36% male; BMI 35 ± 8) were evaluated and compared to O & L controls (BMI 36 ± 7 and 21 ± 3, respectively). Although indexed LVM was higher for T2 compared to L (36 ± 11 vs. 27 ± 6 gm/m2.7, p = <0.0001) it was not different compared to O controls. LV geometry was similarly abnormal in the T2 & O groups, with increased frequency of concentric and eccentric LVH compared to lean controls (Table 1 ). Systolic (SBP) and diastolic (DBP) blood pressure were higher in the T2 vs. O & L (p<0.05). In univariate analysis for T2, indexed LVM correlated with BMI (p<0.0001, R=0.65) but not: BP, gender, race, or fasting plasma glucose. In multiple regression for T2, log index LVM was predicted by BMI (p<0.0001) & gender (p=0.02) (R2=0.46) but not BP, race or fasting plasma glucose. Conclusions: Young people with T2 have higher indexed LVM and abnormal LV geometry compared to lean controls. Obesity, not fasting plasma glucose seems to be a primary factor associated with LVM. These data suggest that obesity is a primary factor in the early cardiac changes in youth with T2. Early weight loss may have a greater beneficial effect on cardiac geometry than glycemic control. Table I: Prevalence of Left Ventricular Geometries