Type 2 diabetes mellitus and obesity in young adults: the extreme phenotype with early cardiovascular dysfunction

Diabet Med. 2014 Jul;31(7):794-8. doi: 10.1111/dme.12431. Epub 2014 Apr 2.

Abstract

Aim: A pilot study to phenotype young adults (< 40 years) with Type 2 diabetes mellitus.

Methods: Twenty people with Type 2 diabetes (aged 18-40 years), 10 lean and 10 obese control subjects underwent detailed assessment, including tagged cardiac magnetic resonance imaging, inflammatory proteins, lipids, vitamin D and maximal oxygen uptake. Outcomes were compared between the group with Type 2 diabetes and the control group.

Results: Mean (standard deviation) age, Type 2 diabetes duration and BMI in the group with Type 2 diabetes were 31.8 (6.6) years, 4.7 (4.0) years and 33.9 (5.8) kg/m(2) respectively. Compared with lean control subjects, those with Type 2 diabetes had more deleterious profiles of hyperlipidaemia, vitamin D deficiency, inflammation and maximal oxygen uptake relative to body mass. However, there was no difference between the group with Type 2 diabetes and the obese control group. The group with Type 2 diabetes had a higher left ventricular mass and a trend towards concentric remodelling compared with the lean control group (P = 0.002, P = 0.052) but not the obese control group (P > 0.05). Peak early diastolic strain rate was reduced in the group with Type 2 diabetes [1.51 (0.24)/s] compared with the lean control [1.97 (0.34)/s, P = 0.001] and obese control [1.78 (0.39)/s, P = 0.042] group.

Conclusions: Young adults with Type 2 diabetes and those with obesity have similar adverse cardiovascular risk profiles, higher left ventricular mass and a trend towards left ventricular concentric remodelling. In addition, those with Type 2 diabetes demonstrate diastolic dysfunction, a known risk marker for future heart failure and mortality.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology*
  • Cardiovascular Diseases / prevention & control
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetic Angiopathies / physiopathology*
  • Diabetic Angiopathies / prevention & control
  • Female
  • Humans
  • Lipids / blood
  • Magnetic Resonance Imaging
  • Male
  • Obesity / complications
  • Obesity / physiopathology*
  • Phenotype
  • Risk Factors
  • United Kingdom
  • Vitamin D Deficiency / physiopathology*

Substances

  • Lipids