Abstract 3148: Development of Heart Failure is a Risk Factor for Incident New Onset Diabetes in the Community
Introduction: Although Diabetes Mellitus (DM) is a well known risk factor for development of congestive heart failure (CHF), the converse relationship is less clear. CHF is a state of increased sympathetic activity and insulin resistance. However no prior study has addressed development of CHF and incident New Onset Diabetes(NOD)
Methods: This is a post-hoc analysis of the NHLBI Limited Access Dataset of the Framingham Offspring Study (n=4989). Patients with history of DM or CHF (n=98) at baseline were excluded. Patients who developed NOD before CHF during follow-up were also excluded. Remaining 4222 patients were included in this analysis and followed up for a mean duration of 23.6±5.3 years. NOD was screened for in every visit and was defined as fasting blood glucose greater than 125mg%, random blood glucose greater than 200mg% or use of anti-diabetic medication. Patients who developed CHF on follow up were compared to patients who did not develop CHF for NOD. Cox proportional hazard regression was used to adjust for baseline differences.
Results: 470 patients developed NOD on follow up. 119 patients developed CHF. 7.1%patients had hypertension at baseline, 48% were males and mean age was 36±10 years. 0.5% were on ACE Inhibitors, 8.3% were on beta blockers and 0.4% were on lipid lowering therapy. Mean LDL and HDL was 124 mg% and 51 mg% and triglyceride level was 308 mg%. Figure⇓ shows K-M curve for freedom from NOD. Development of CHF (HR, 95% CI, p value) was associated with increased risk of NOD (2.71, 1.88 –3.90, <0.0001).
Conclusion: In this large population based study, development of CHF is a possible ‘risk factor’ for development of diabetes.