Structural and Functional Cardiac Abnormalities in Adolescent Girls with Poorly Controlled Type 2 Diabetes

  1. Gillian A. Whalley, PHD, DMU, FCSANZ, FASE1,
  2. Silmara Gusso, MSC2,
  3. Paul Hofman, MBCHB, FRACP2,
  4. Wayne Cutfield, MBCHB, FRACP2,
  5. Katrina K. Poppe, MSC1,
  6. Robert N. Doughty, MBCHB, MD, FRCP, FRACP, FCSANZ1 and
  7. J. Chris Baldi, PHD, FACSM3
  1. 1Department of Medicine, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand;
  2. 2The Liggins Institute, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand;
  3. 3Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona.
  1. Corresponding author: Gillian Whalley, g.whalley{at}auckland.ac.nz

Abstract

OBJECTIVE Type 2 diabetes is associated with left ventricular hypertrophy (LVH) and diastolic dysfunction, which may eventually lead to clinical heart failure. We sought to determine the cardiovascular effects of adolescent-onset type 2 diabetes.

RESEARCH DESIGN AND METHODS We recruited diabetic girls (8 with type 2 and 11 with type 1 diabetes) from a hospital diabetes service and nondiabetic control subjects (9 lean and 11 overweight) from the schools of the diabetic subjects. Echocardiography and measurements were performed by a single observer, blinded to subject group allocation, and included M-mode left ventricular dimensions, two-dimensional left ventricular mass, Doppler diastolic flows, estimation of left ventricular filling pressure, and systolic longitudinal motion. Left ventricular mass was indexed to height and fat-free body mass. ANOVA was used to compare the groups.

RESULTS The groups were similar in age and height, but significant differences in body composition were observed. Subjects with type 2 diabetes had larger left ventricular dimensions and left ventricular mass, which persisted when indexed to height. Diastolic filling was impaired in both diabetic groups, and systolic longitudinal function was lower in the type 2 diabetic group. Half of the group with type 2 diabetes met the published criteria for LVH and left ventricular dilatation; 25% had evidence of elevated left ventricular filling pressure in association with structural abnormalities.

CONCLUSIONS This study has demonstrated preclinical abnormalities of cardiac structure and function in adolescent girls with type 2 diabetes, despite the short duration of diabetes and highlights the potential high cardiovascular risk occurring in adolescent type 2 diabetes.

Footnotes

  • None of the funding agencies had any role in the design and conduct of the study, collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

  • 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.

    • Received November 6, 2008.
    • Accepted January 26, 2009.
  • Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

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  1. Diabetes Care vol. 32 no. 5 883-888
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