Reduction in myocardial strain is evident in adolescents and young adults with obesity and type 2 diabetes

Jessica E. Haley; Gao Zhiqian; Khoury R. Philip; Madsen L. Nicolas; Kimball R. Thomas; Dolan M. Lawrence; Urbina M. Elaine

doi:10.1111/pedi.12961

Reduction in myocardial strain is evident in adolescents and young adults with obesity and type 2 diabetes

Jessica E. Haley, Gao Zhiqian, Khoury R. Philip, Madsen L. Nicolas, Kimball R. Thomas, Dolan M. Lawrence, Urbina M. Elaine

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Aims/hypothesis: Heart failure is a complication of type 2 diabetes (T2DM). Echocardiography can identify subclinical systolic dysfunction in adults with T2DM. We hypothesized that reduced systolic strain was present in youth with T2DM. Methods: Global longitudinal strain (GLS) was measured in 151 subjects with T2DM matched to lean (L = 146), and obese (O = 162) subjects (23.0 ± 4.0 years, 35% male, 63% African American). Anthropometrics, BP, HR, labs, and echocardiograms were obtained. ANOVA was performed to compare differences among groups, and ANCOVA to determine if T2DM remained an independent predictor after corrections. Results: BP, lipid levels, and metabolic control worsened and GLS was reduced from L to O to T2DM. BMI was lower in L than O or T2DM. Global longitudinal strain rate (GLSR) was lower and LVM/ht^2.7 was higher in O and T2DM as compared to L (all P ≤.05). Presence of T2DM was an independent determinant of GLS and GLSR adjusted for most CV risk factors, but lost significance when BMI was added to the model. GLS = −21.6-age*0.088 - male*1.8 + 0.12*BMI + 0.045*DBP + 0.058*HR - 0.023*HDL (R² = 0.38, P ≤.0001); GLSR = −1.20-male*0.093 + WHR*0.48 + DBP*0.0029 (R² = 0.23, P ≤.0001). Conclusion: Both adiposity and T2DM have a deleterious effect on systolic cardiac function. Treatment of obesity in youth is necessary for prevention of future heart failure.

Original language	English (US)
Pages (from-to)	243-250
Number of pages	8
Journal	Pediatric Diabetes
Volume	21
Issue number	2
DOIs	https://doi.org/10.1111/pedi.12961
State	Published - Mar 1 2020
Externally published	Yes

Keywords

diabetes mellitus
left ventricular dysfunction
myocardial strain
obesity
pediatrics

ASJC Scopus subject areas

Internal Medicine
Pediatrics, Perinatology, and Child Health
Endocrinology, Diabetes and Metabolism

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10.1111/pedi.12961

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@article{562582d0664d41818f3dea12002dbe93,

title = "Reduction in myocardial strain is evident in adolescents and young adults with obesity and type 2 diabetes",

abstract = "Aims/hypothesis: Heart failure is a complication of type 2 diabetes (T2DM). Echocardiography can identify subclinical systolic dysfunction in adults with T2DM. We hypothesized that reduced systolic strain was present in youth with T2DM. Methods: Global longitudinal strain (GLS) was measured in 151 subjects with T2DM matched to lean (L = 146), and obese (O = 162) subjects (23.0 ± 4.0 years, 35% male, 63% African American). Anthropometrics, BP, HR, labs, and echocardiograms were obtained. ANOVA was performed to compare differences among groups, and ANCOVA to determine if T2DM remained an independent predictor after corrections. Results: BP, lipid levels, and metabolic control worsened and GLS was reduced from L to O to T2DM. BMI was lower in L than O or T2DM. Global longitudinal strain rate (GLSR) was lower and LVM/ht2.7 was higher in O and T2DM as compared to L (all P ≤.05). Presence of T2DM was an independent determinant of GLS and GLSR adjusted for most CV risk factors, but lost significance when BMI was added to the model. GLS = −21.6-age*0.088 - male*1.8 + 0.12*BMI + 0.045*DBP + 0.058*HR - 0.023*HDL (R2 = 0.38, P ≤.0001); GLSR = −1.20-male*0.093 + WHR*0.48 + DBP*0.0029 (R2 = 0.23, P ≤.0001). Conclusion: Both adiposity and T2DM have a deleterious effect on systolic cardiac function. Treatment of obesity in youth is necessary for prevention of future heart failure.",

keywords = "diabetes mellitus, left ventricular dysfunction, myocardial strain, obesity, pediatrics",

author = "Haley, {Jessica E.} and Gao Zhiqian and Philip, {Khoury R.} and Nicolas, {Madsen L.} and Thomas, {Kimball R.} and Lawrence, {Dolan M.} and Elaine, {Urbina M.}",

note = "Funding Information: We would like to acknowledge the excellent work of all of our cardiovascular technicians and Research Assistants and we would like to thank the participants of the CV Aging study without whose support this study would not be possible. The project described was funded by (NHLBI) R01 HL105591 and partially funded by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant 8 UL1 TR000077‐04. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The guarantor is U.M.E. Funding Information: T.R.K., L.M.D., and E.M.U. received grant funding for this project from NIH (NHLBI) R01 HL105591. They have no other disclosures to report. The other authors have no disclosures to report. Publisher Copyright: {\textcopyright} 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",

year = "2020",

month = mar,

day = "1",

doi = "10.1111/pedi.12961",

language = "English (US)",

volume = "21",

pages = "243--250",

journal = "Pediatric Diabetes",

issn = "1399-543X",

publisher = "Blackwell Munksgaard",

number = "2",

}

TY - JOUR

T1 - Reduction in myocardial strain is evident in adolescents and young adults with obesity and type 2 diabetes

AU - Haley, Jessica E.

AU - Zhiqian, Gao

AU - Philip, Khoury R.

AU - Nicolas, Madsen L.

AU - Thomas, Kimball R.

AU - Lawrence, Dolan M.

AU - Elaine, Urbina M.

N1 - Funding Information: We would like to acknowledge the excellent work of all of our cardiovascular technicians and Research Assistants and we would like to thank the participants of the CV Aging study without whose support this study would not be possible. The project described was funded by (NHLBI) R01 HL105591 and partially funded by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant 8 UL1 TR000077‐04. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The guarantor is U.M.E. Funding Information: T.R.K., L.M.D., and E.M.U. received grant funding for this project from NIH (NHLBI) R01 HL105591. They have no other disclosures to report. The other authors have no disclosures to report. Publisher Copyright: © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

PY - 2020/3/1

Y1 - 2020/3/1

N2 - Aims/hypothesis: Heart failure is a complication of type 2 diabetes (T2DM). Echocardiography can identify subclinical systolic dysfunction in adults with T2DM. We hypothesized that reduced systolic strain was present in youth with T2DM. Methods: Global longitudinal strain (GLS) was measured in 151 subjects with T2DM matched to lean (L = 146), and obese (O = 162) subjects (23.0 ± 4.0 years, 35% male, 63% African American). Anthropometrics, BP, HR, labs, and echocardiograms were obtained. ANOVA was performed to compare differences among groups, and ANCOVA to determine if T2DM remained an independent predictor after corrections. Results: BP, lipid levels, and metabolic control worsened and GLS was reduced from L to O to T2DM. BMI was lower in L than O or T2DM. Global longitudinal strain rate (GLSR) was lower and LVM/ht2.7 was higher in O and T2DM as compared to L (all P ≤.05). Presence of T2DM was an independent determinant of GLS and GLSR adjusted for most CV risk factors, but lost significance when BMI was added to the model. GLS = −21.6-age*0.088 - male*1.8 + 0.12*BMI + 0.045*DBP + 0.058*HR - 0.023*HDL (R2 = 0.38, P ≤.0001); GLSR = −1.20-male*0.093 + WHR*0.48 + DBP*0.0029 (R2 = 0.23, P ≤.0001). Conclusion: Both adiposity and T2DM have a deleterious effect on systolic cardiac function. Treatment of obesity in youth is necessary for prevention of future heart failure.

AB - Aims/hypothesis: Heart failure is a complication of type 2 diabetes (T2DM). Echocardiography can identify subclinical systolic dysfunction in adults with T2DM. We hypothesized that reduced systolic strain was present in youth with T2DM. Methods: Global longitudinal strain (GLS) was measured in 151 subjects with T2DM matched to lean (L = 146), and obese (O = 162) subjects (23.0 ± 4.0 years, 35% male, 63% African American). Anthropometrics, BP, HR, labs, and echocardiograms were obtained. ANOVA was performed to compare differences among groups, and ANCOVA to determine if T2DM remained an independent predictor after corrections. Results: BP, lipid levels, and metabolic control worsened and GLS was reduced from L to O to T2DM. BMI was lower in L than O or T2DM. Global longitudinal strain rate (GLSR) was lower and LVM/ht2.7 was higher in O and T2DM as compared to L (all P ≤.05). Presence of T2DM was an independent determinant of GLS and GLSR adjusted for most CV risk factors, but lost significance when BMI was added to the model. GLS = −21.6-age*0.088 - male*1.8 + 0.12*BMI + 0.045*DBP + 0.058*HR - 0.023*HDL (R2 = 0.38, P ≤.0001); GLSR = −1.20-male*0.093 + WHR*0.48 + DBP*0.0029 (R2 = 0.23, P ≤.0001). Conclusion: Both adiposity and T2DM have a deleterious effect on systolic cardiac function. Treatment of obesity in youth is necessary for prevention of future heart failure.

KW - diabetes mellitus

KW - left ventricular dysfunction

KW - myocardial strain

KW - obesity

KW - pediatrics

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U2 - 10.1111/pedi.12961

DO - 10.1111/pedi.12961

M3 - Article

C2 - 31825129

AN - SCOPUS:85076890984

SN - 1399-543X

VL - 21

SP - 243

EP - 250

JO - Pediatric Diabetes

JF - Pediatric Diabetes

IS - 2

ER -

Reduction in myocardial strain is evident in adolescents and young adults with obesity and type 2 diabetes

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