Diabetes, gender, and left ventricular structure in African-Americans: the atherosclerosis risk in communities study.
BACKGROUND
Cardiovascular risk associated with diabetes may be partially attributed to left ventricular structural abnormalities. However, the relations between left ventricular structure and diabetes have not been extensively studied in African-Americans.


METHODS
We studied 514 male and 965 female African-Americans 51 to 70 years old, in whom echocardiographic left ventricular mass measurements were collected for the ARIC Study. In these, we investigated the independent association of diabetes with left ventricular structural abnormalities.


RESULTS
Diabetes, hypertension and obesity prevalences were 22%, 57% and 45%, respectively. Unindexed left ventricular mass was higher with diabetes in both men (238.3 +/- 79.4 g vs. 213.7 +/- 58.6 g; p < 0.001) and women (206.4 +/- 61.5 g vs. 176.9 +/- 50.1 g; p < 0.001), respectively. Prevalence of height-indexed left ventricular hypertrophy was higher in women while increased relative wall thickness was similar in men and women. Those with diabetes had higher prevalences of height-indexed left ventricular hypertrophy (52% vs. 32%; p < 0.001), and of increased relative wall thickness (73% vs. 64%; p = 0.002). Gender-adjusted associations of diabetes with left ventricular hypertrophy (OR = 2.29 95% CI:1.79-2.94) were attenuated after multiple adjustments in logistic regression (OR = 1.50 95% CI:1.12-2.00). Diabetes was associated with higher left ventricle diameter (OR = 2.13 95% CI:1.28-3.53) only in men and with higher wall thickness (OR = 1.89 95% CI:1.34-2.66) only in women. Attenuations in diabetes associations were frequently seen after adjustment for obesity indices.


CONCLUSIONS
In African-Americans, diabetes is associated with left ventricular hypertrophy and, with different patterns of left ventricular structural abnormalities between genders. Attenuation seen in adjusted associations suggests that the higher frequency of structural abnormalities seen in diabetes may be due to factors other than hyperglycemia.
Foppa
Murilo
M
Graduate Studies Program in Cardiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. mfoppa@cpovo.net
Duncan
Bruce B
BB
Arnett
Donna K
DK
Benjamin
Emelia J
EJ
Liebson
Philip R
PR
Manolio
Teri A
TA
Skelton
Thomas N
TN
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012737:Sex Factors; D014463:Ultrasonography; D014481:United States / Q000208:ethnology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*