title: Cardiac geometry and function in diabetic or prediabetic adolescents and young adults: the Strong Heart Study.
abstract: 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.
  
  
  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.
authors.affiliation: Department of Clinical and Experimental Disease, Federico II University Hospital, Naples, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: De Marco
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Simone
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Roman
authors.forename: Marcello
authors.initials: M
authors.lastname: Chinali
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
authors.forename: Darren
authors.initials: D
authors.lastname: Calhoun
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
mesh_terms: D000293:Adolescent; D000328:Adult; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology / Q000209:etiology; D008297:Male; D011236:Prediabetic State / Q000453:epidemiology / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology; D055815:Young Adult