Sex-Specific Determinants of Left Ventricular Mass in Pre-Diabetic and Type 2 Diabetic Subjects
The Augsburg Diabetes Family Study
- Bernhard Kuch, MD1,
- Wolfgang von Scheidt, MD1,
- Wolfgang Peter, MD1,
- Angela Döring, MD2,
- Wolfgang Piehlmeier, MD3,
- Rüdiger Landgraf, MD3 and
- Christa Meisinger, MD, MPH24
- 1Department of Internal Medicine I–Cardiology, Central Hospital of Augsburg, Augsburg, Germany
- 2GSF–National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany
- 3Diabetes Centre, Department of Internal Medicine, Innenstadt, University of Munich, Munich, Germany
- 4Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany
- Address correspondence and reprint requests to Bernhard Kuch, MD, I Medizinische Klinik, Klinikum Augsburg, Stenglinstrasse 2, D-86156 Augsburg, Germany. E-mail: bernhard.kuch{at}1med.zk-augsburg-med.de
Abstract
OBJECTIVE— Obesity and hypertension are regarded as the most important determinants of left ventricular mass in the community. Little is known about sex-specific influences of obesity, hypertension, and other risk factors on left ventricular mass in pre-diabetic or diabetic subjects.
RESEARCH DESIGN AND METHODS— We examined how body composition, blood pressure, and other factors are related to left ventricular structure in elderly subjects (mean age 62 years, 88% of women postmenopausal) with pre-diabetes (impaired fasting glucose or impaired glucose tolerance; n = 112) and diabetes with (n = 181) and without (n = 213) overt cardiovascular disease (CVD).
RESULTS— Neither microalbuminuria nor physical activity was significantly associated with left ventricular mass. In pre-diabetic as well as diabetic subjects with CVD, mainly BMI and fat mass, particularly in women, were correlated with left ventricular mass. In the diabetic group without overt CVD, fat mass was only slightly correlated with left ventricular mass. In the latter group waist-to-hip-ratio, and, only in men, systolic blood pressure, glucose, and A1C were moderately correlated with left ventricular mass. Multiregression analysis over all groups again revealed fat mass as the main determinant of left ventricular mass in women. In women but not men obesity was associated with a significantly increased prevalence of concentric left ventricular hypertrophy.
CONCLUSIONS— In pre-diabetic and diabetic elderly subjects fat mass is the major determinant of left ventricular mass in women but not in men. These results may partly explain sex differences in CVD mortality in obese elderly diabetic subjects and underscore the need for activities focused on weight reduction.
- CVD, cardiovascular disease
- FFM, free fat mass
- IFG, impaired fasting glucose
- IGT, impaired glucose tolerance
- WHR, waist-to-hip ratio
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
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- Accepted December 28, 2006.
- Received October 14, 2006.
- DIABETES CARE
