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Original Research
Relations Between Subclinical Disease Markers and Type 2 Diabetes, Metabolic Syndrome, and Incident Cardiovascular Disease: The Jackson Heart Study
Vanessa Xanthakis, Jung Hye Sung, Tandaw E. Samdarshi, Alethea N. Hill, Solomon K. Musani, Mario Sims, Kamel A. Ghraibeh, Philip R. Liebson, Herman A. Taylor, Ramachandran S. Vasan, Ervin R. Fox
Diabetes Care 2015 Mar; dc142460. https://doi.org/10.2337/dc14-2460
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Abstract

OBJECTIVE The presence of subclinical disease measures has been directly associated with the development of cardiovascular disease (CVD) in whites. African Americans (AAs) in the U.S. are at higher risk of CVD compared with non-Hispanic whites; however, data on the prevalence of subclinical disease measures in AAs and their association to CVD remains unclear and may explain the higher CVD risk in this group.

RESEARCH DESIGN AND METHODS We evaluated 4,416 participants attending the first examination of the Jackson Heart Study (mean age 54 years; 64% women) with available subclinical disease measures.

RESULTS There were 1,155 participants (26%) with subclinical disease, defined as the presence of one or more of the following: peripheral arterial disease, left ventricular hypertrophy (LVH), microalbuminuria, high coronary artery calcium (CAC) score, and low left ventricular ejection fraction. In cross-sectional analyses using multivariable-adjusted logistic regression, participants with the metabolic syndrome (MetS) or diabetes (DM) had higher odds of subclinical disease compared with those without MetS and DM (odds ratios 1.55 [95% CI 1.30–1.85] and 2.86 [95% CI 2.32–3.53], respectively). Furthermore, the presence of a high CAC score and LVH were directly associated with the incidence of CVD (265 events) in multivariable-adjusted Cox proportional hazards regression models (P < 0.05). In prospective analyses, having MetS or DM significantly increased the hazard of incident CVD, independent of the presence of subclinical disease (P < 0.001).

CONCLUSIONS In our community-based sample of AAs, we observed a moderately high prevalence of subclinical disease, which in turn translated into a greater risk of CVD, especially in people with MetS and DM.

  • Received October 16, 2014.
  • Accepted February 20, 2015.
  • © 2015 by the American Diabetes Association. 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.
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Diabetes Care: 44 (3)

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March 2021
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Relations Between Subclinical Disease Markers and Type 2 Diabetes, Metabolic Syndrome, and Incident Cardiovascular Disease: The Jackson Heart Study
Vanessa Xanthakis, Jung Hye Sung, Tandaw E. Samdarshi, Alethea N. Hill, Solomon K. Musani, Mario Sims, Kamel A. Ghraibeh, Philip R. Liebson, Herman A. Taylor, Ramachandran S. Vasan, Ervin R. Fox
Diabetes Care Mar 2015, dc142460; DOI: 10.2337/dc14-2460

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Relations Between Subclinical Disease Markers and Type 2 Diabetes, Metabolic Syndrome, and Incident Cardiovascular Disease: The Jackson Heart Study
Vanessa Xanthakis, Jung Hye Sung, Tandaw E. Samdarshi, Alethea N. Hill, Solomon K. Musani, Mario Sims, Kamel A. Ghraibeh, Philip R. Liebson, Herman A. Taylor, Ramachandran S. Vasan, Ervin R. Fox
Diabetes Care Mar 2015, dc142460; DOI: 10.2337/dc14-2460
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© 2021 by the American Diabetes Association. Diabetes Care Print ISSN: 0149-5992, Online ISSN: 1935-5548.