Abstract 17562: The Longitudinal Effects of Obesity and Type 2 Diabetes on Cardiac Function in Adolescents and Young Adults: A Prospective Cohort Study
Background: Adults with obesity or obesity-related type 2 diabetes mellitus (T2DM) are at increased risk for early cardiovascular disease, however evidence that these risk factors manifest their cardiac burden beginning in the pediatric age range is unresolved.
Objective: We aim to study the longitudinal effects of obesity and obesity-related T2DM on cardiac systolic and diastolic function in adolescents and young adults.
Methods: Longitudinal cardiac function data was assessed over a 7 year period by ECHO in 282 participants. Subjects were enrolled in one of three cohorts: lean, obese or obese with T2DM (obese diabetics). Group differences were assessed by general linear models using covariant analysis. Those participants who migrated between study arms (eg, lean to obese) during the study period were excluded in a secondary analysis.
Results: Participants with obesity and obesity-related T2DM were found to have abnormal cardiac function relative to lean controls, and this difference worsened relative to controls longitudinally (p<0.05). There was no significant change in systolic function between groups (p>0.05). The diastolic function in the obese diabetics across multiple measures (Table 1) was significantly decreased relative to the other groups (p<0.05). Regression analysis of covariates showed that in addition to group, other significant determinants of diastolic function included systolic and diastolic BP z-scores, BMI z-score and change in z-scores over time, and gender. Secondary analysis, performed excluding those who migrated between study groups during the follow up period, showed no change to the results.
Conclusion: Adolescents and young adults with obesity and obesity-related T2DM demonstrate decreased diastolic function compared to lean controls. This decreased cardiac function is worse with increased duration of exposure suggesting a progressive risk for adult onset heart disease beginning in the pediatric age range.
- © 2013 by American Heart Association, Inc.