Sex-specific determinants of left ventricular mass in pre-diabetic and type 2 diabetic subjects: the Augsburg Diabetes Family Study.
OBJECTIVE
Obesity and hypertension are regarded as the most important determinants of left ventricular mass in the community. Little is known about sex-specific influences of obesity, hypertension, and other risk factors on left ventricular mass in pre-diabetic or diabetic subjects.


METHODS
We examined how body composition, blood pressure, and other factors are related to left ventricular structure in elderly subjects (mean age 62 years, 88% of women postmenopausal) with pre-diabetes (impaired fasting glucose or impaired glucose tolerance; n = 112) and diabetes with (n = 181) and without (n = 213) overt cardiovascular disease (CVD).


RESULTS
Neither microalbuminuria nor physical activity was significantly associated with left ventricular mass. In pre-diabetic as well as diabetic subjects with CVD, mainly BMI and fat mass, particularly in women, were correlated with left ventricular mass. In the diabetic group without overt CVD, fat mass was only slightly correlated with left ventricular mass. In the latter group waist-to-hip-ratio, and, only in men, systolic blood pressure, glucose, and A1C were moderately correlated with left ventricular mass. Multiregression analysis over all groups again revealed fat mass as the main determinant of left ventricular mass in women. In women but not men obesity was associated with a significantly increased prevalence of concentric left ventricular hypertrophy.


CONCLUSIONS
In pre-diabetic and diabetic elderly subjects fat mass is the major determinant of left ventricular mass in women but not in men. These results may partly explain sex differences in CVD mortality in obese elderly diabetic subjects and underscore the need for activities focused on weight reduction.
Kuch
Bernhard
B
Department of Internal Medicine I-Cardiology, Central Hospital of Augsburg, Augsburg, Germany. bernhard.kuch@1med.zk-augsburg-med.de
von Scheidt
Wolfgang
W
Peter
Wolfgang
W
Döring
Angela
A
Piehlmeier
Wolfgang
W
Landgraf
Rüdiger
R
Meisinger
Christa
C
D000273:Adipose Tissue / Q000033:anatomy & histology*; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D049628:Body Size; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000235:genetics; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005260:Female; D005858:Germany; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology* / Q000235:genetics; D012044:Regression Analysis; D012307:Risk Factors; D012727:Sex Characteristics; D016277:Ventricular Function, Left / Q000502:physiology*