Cardiac geometry and function in diabetic or prediabetic adolescents and young adults: the Strong Heart Study

Diabetes Care. 2011 Oct;34(10):2300-5. doi: 10.2337/dc11-0191. Epub 2011 Aug 26.


Objective: The aim of this study was to evaluate whether diabetes (DM) and impaired fasting glucose (IFG) were associated with early alterations in left ventricular geometry and function in a large population of adolescents and young adults independently of major confounders.

Research design and methods: We analyzed echocardiographic data of 1,624 14- to 39-year-old participants (mean age 26.6 ± 7.7 years; 57% female) without prevalent cardiovascular disease from the fourth Strong Heart Study examination; 179 (11%) participants had DM and 299 (18%) had IFG.

Results: Participants with DM and IFG were older and more often obese and hypertensive than participants with normal fasting glucose (NFG) (all P < 0.05). After adjustment for age, sex, systolic blood pressure, and body fat, diabetic and IFG participants had higher left ventricular mass index than those with NFG (41.5 ± 8.7 and 39.6 ± 9.2 vs. 35.6 ± 7.8 g/m(2.7)) and reduced stress-corrected midwall shortening (98 ± 8.6 and 99 ± 7.5 vs. 101 ± 8.5%; all P < 0.05). The prevalence of left ventricular hypertrophy was higher in DM (20%) and IFG (17%) than in NFG participants (12%; P < 0.05). Compared with the other groups, DM was also associated with higher prevalence of inappropriate left ventricular mass, concentric geometry, and more diastolic abnormalities independently of covariates (all P < 0.05).

Conclusions: In a population of adolescents and young adults, DM is independently associated with early unfavorable cardiovascular phenotype characterized by increased left ventricular mass, concentric geometry, and early preclinical systolic and diastolic dysfunction; early cardiovascular alterations are also present in participants with prediabetes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / physiopathology*
  • Echocardiography
  • Female
  • Hemodynamics
  • Humans
  • Hypertension / epidemiology
  • Hypertension / etiology
  • Hypertrophy, Left Ventricular / epidemiology
  • Hypertrophy, Left Ventricular / etiology
  • Male
  • Prediabetic State / epidemiology
  • Prediabetic State / physiopathology*
  • Ventricular Function, Left / physiology
  • Young Adult