title: Subclinical left ventricular diastolic dysfunction and incident type 2 diabetes risk: the Korean Genome and Epidemiology Study.
abstract: Subclinical left ventricular (LV) diastolic dysfunction in type 2 diabetes (T2D) is a common finding and represents an early sign of diabetic cardiomyopathy. However, the relationship between LV diastolic dysfunction and the incident T2D has not been previously studied.
  
  
  
  A total of 1817 non-diabetic participants (mean age, 54 years; 48% men) from the Korean Genome and Epidemiology Study who were free of cardiovascular disease were studied. LV structure and function were assessed by conventional echocardiography and tissue Doppler imaging. Subclinical LV diastolic dysfunction was defined using age-specific cutoff limits for early diastolic (Em) velocity, mitral E/Em ratio, and left atrial volume index.
  
  
  
  During the 6-year follow-up period, 273 participants (15%) developed T2D. Participants with incident T2D had greater LV mass index (86.7 ± 16.4 vs. 91.2 ± 17.0 g/m2), worse diastolic function, reflected by lower Em velocity (7.67 ± 1.80 vs. 7.47 ± 1.70) and higher E/Em ratio (9.19 ± 2.55 vs. 10.23 ± 3.00), and higher prevalence of LV diastolic dysfunction (34.6 vs. 54.2%), compared with those who did not develop T2D (all P < 0.001). In a multivariate logistic regression model, lower Em velocity (odd ratio [OR], 0.867; 95% confidence interval [CI] 0.786-0.957) and the presence of LV diastolic dysfunction (OR, 1.617; 95% CI 1.191-2.196) were associated with the development of T2D, after adjusting for potential confounding factors.
  
  
  
  In a community-based cohort, the presence of subclinical LV diastolic dysfunction was a predictor of the progression to T2D. These data suggest that the echocardiographic assessment of LV diastolic function may be helpful in identifying non-diabetic subjects at risk of incident T2D.
authors.affiliation: Department of Endocrinology, Hallym University Kangdong Sacred Heart Hospital, Seoul, South Korea.
authors.forename: Juri
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Cardiology, Korea University Ansan Hospital, Ansan, South Korea.
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Korea University Ansan Hospital, Ansan, South Korea. cardioguy@korea.ac.kr.|Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan, Gyeonggi-do, 15355, South Korea. cardioguy@korea.ac.kr.
authors.forename: Seong Hwan
authors.identifier: 0000-0002-8019-2713
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Korea University Ansan Hospital, Ansan, South Korea.
authors.forename: Sunwon
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Korea University Ansan Hospital, Ansan, South Korea.
authors.forename: Sang Yup
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea.
authors.forename: Hong-Euy
authors.initials: HE
authors.lastname: Lim
authors.affiliation: Department of Cardiology, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Goo-Yeong
authors.initials: GY
authors.lastname: Cho
authors.affiliation: Department of Cardiology, Kangbuk Samsung Hospital, Seoul, South Korea.
authors.forename: Ki-Chul
authors.initials: KC
authors.lastname: Sung
authors.affiliation: Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, South Korea.
authors.forename: Jang-Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Foods and Nutrition, Kookmin University, Seoul, South Korea.
authors.forename: Inkyung
authors.initials: I
authors.lastname: Baik
authors.affiliation: Department of Cardiology, Gachon University Gil Medical Center, Incheon, South Korea.
authors.forename: Kwang Kon
authors.initials: KK
authors.lastname: Koh
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, South Korea.
authors.forename: Jung Bok
authors.initials: JB
authors.lastname: Lee
authors.affiliation: Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, South Korea.
authors.forename: Seung Ku
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, South Korea.
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
mesh_terms: D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D015894:Genome, Human / Q000235:genetics*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics*
keywords: Cohort; Diastolic dysfunction; Left ventricle; Tissue Doppler echocardiography; Type 2 diabetes