Abstract 11266: Obesity Contributes to Accelerated Disease Progression in the Japanese Patients With Early-Stage Diabetes: Sub-Analysis From the DIANA Study
Backgrounds: Obesity is associated with glycemic abnormality and frequent cardiovascular events. As visceral adiposity and glycemic abnormality enhance inflammatory activity, diabetic patients with obesity may have progressive atheroma burden. The DIANA (DIAbetes and diffuse coronary NArrowing) study evaluated the impact of glucose lowering therapy on angiographical disease progression in early-stage diabetics. This study sought to characterize disease progression in early-stage diabetics with obesity.
Methods: A total of 302 Japanese patients (65years, male/female: 261/41) with impaired glucose tolerance or newly diagnosed diabetes in the DIANA study was stratified into non-obesity (n=195) and obesity group (n=107). Japan Society for the Study of Obesity defined obesity in Japanese as BMI ≥25. Coronary atherosclerosis at baseline and 1 year was evaluated by quantitative computed analysis. A total of all angiographical atherosclerotic lesion length were defined as total lesion length (TLL), and compared in two groups.
Results: Obese patients were more likely to be younger (61 v. 66 years, p<0.01) and have a higher level of fasting (9.7 v. 7.0 IU/l, p=0.003) and postprandial insulin (124.5 v. 99.9 IU/l, p=0.009), triglyceride (172 v. 147 mg/dl, p<0.05), higher diastolic BP (71 v. 68 mmHg, p=0.01) with lower adiponectin level (7.1 v. 8.1 mg/dl, p=0.05). Baseline TLL was similar between two groups (12.3 v. 13.5mm, p=0.45). On serial evaluation, obese patients had greater disease progression, reflected by a larger percent change in TLL (31.2 v. 12.1%, p<0.05). The improvement of glycemic abnormality at 1 year was associated with less disease progression in non-obese and obese groups (Figure).
Conclusions: Obese patients with early-stage diabetes exhibit profound disease progression. They also demonstrate the benefits from favorable glycemic control. Our findings indicate progressive but modifiable form of disease in early stage diabetics with obesity.
- © 2013 by American Heart Association, Inc.