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Subclinical left ventricular (LV) diastolic dysfunction in type 2 diabetes is a common finding and represents an early sign of diabetic cardiomyopathy. However, the relations of LV diastolic dysfunction and incidence of type 2 diabetes has never been studied.
We followed up 1817 non-diabetic participants (mean age, 54 years; 48% men) free of cardiovascular disease from the Korean Genome and Epidemiology Study for 6 years. LV structure and function were measured by tissue Doppler imaging echocardiography. Subclinical LV diastolic dysfunction was defined using age-specific cutoff limit for early diastolic (Em) velocity, mitral E/Em ratio, and left atrial volume index.
During 6-year follow-up, 273 participants (15%) developed type 2 diabetes. In a multivariate-adjusted regression model, lower Em velocity (odd ratio [OR], 0.858; 95% confidence interval [CI], 0.771 - 0.955; P = 0.005), higher E/Em ratio (OR, 1.076; 95% CI, 1.014 - 1.143, P = 0.016), and the presence of LV diastolic function (OR, 1.794; 95% CI, 1.286 - 2.504, P = 0.001) were associated with the development of type 2 diabetes in prediabetes. However, no echocardiographic parameters were independent predictors of incident type 2 diabetes in participants with normal glucose tolerance.
In a community-based cohort undergoing 6 years of follow-up, progression to type 2 diabetes in prediabetic participants could be predicted by the presence of subclinical LV diastolic dysfunction, independently of age, hypertension, prevalence of overweight and obesity, and initial fasting blood glucose.