title: Heart failure as a risk factor for diabetes mellitus.
abstract: BACKGROUND
  Diabetes mellitus (DM) is a well-recognized risk factor for heart failure (HF). We hypothesized that HF also increases the risk for DM.
  
  
  OBJECTIVE
  We explored the hypothesis that HF is a risk factor for DM.
  
  
  METHODS
  The Cardiovascular Health Study was a prospective cohort study of cardiovascular risk in ambulatory older adults. We used a limited-access dataset provided by the National Heart, Lung and Blood Institute. The impact of HF at baseline on DM after 3 or 4 years was examined in a cohort of 3,748 nondiabetic participants aged ≥65 years. The magnitude and significance of the association were evaluated using logistic regression models. Analyses were performed with and without adjustment for confounders and separately among subjects with normal and impaired fasting glucose at baseline.
  
  
  RESULTS
  Among subjects with normal fasting glucose at baseline, HF significantly increased the odds of developing impaired fasting glucose after 3 or 4 years [odds ratio (OR) 2.18, 95% confidence interval (CI) 1.03-4.61, p = 0.043] or overt DM (OR 4.78, 95% CI 1.84-12.4, p < 0.001). After adjusting for demographic and biomedical factors, HF remained significantly associated with a worsening DM status (OR 2.43, 95% CI 1.38-4.29, p = 0.002).
  
  
  CONCLUSIONS
  In the elderly population, the presence of HF more than doubles the incidence of DM within a few years. This association remains significant when adjusting for age, gender and cardiovascular comorbidities.
authors.affiliation: Department of Cardiology, University of South Florida, Tampa, Fla., USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Guglin
authors.forename: Kristian
authors.initials: K
authors.lastname: Lynch
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Krischer
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D058065:Diabetic Cardiomyopathies / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D004812:Epidemiologic Methods; D005215:Fasting / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose