Dataset Information

Fasting glucose and insulin resistance trajectories during young adulthood and mid-life cardiac structure and function.

ABSTRACT: AIMS:We assessed whether fasting glucose (FG) and insulin resistance (IR) trajectories during young adulthood are associated with changes in cardiac structure and function. METHODS:We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (baseline: 1985-1986). Echocardiography was performed after 25 (Y25) and 30?years of follow-up. Group-based modeling was used to determine 25-year trajectories in FG and IR. We assessed differences at Y25 and 5-year longitudinal change in cardiac structure and function after adjustment for demographics, cumulative exposure to traditional cardiovascular risk factors, and baseline FG or IR. RESULTS:We identified five FG trajectory groups among 2414 individuals and three IR trajectory groups among 2358 individuals. Moderate-increasing FG trajectory was associated with lower lateral E' velocity (difference: -0.9?cm/s, 95%CI: -0.3, -1.5) and with greater left ventricular (LV) mass index (difference: 2.7?g/m2.7, 95%CI: 0.7, 4.7) at Y30 compared to low-stable FG. High-increasing IR trajectory was associated with lower lateral E' velocity and septal E' velocity at Y30 compared to low-decreasing IR trajectory. CONCLUSIONS:Trajectories in FG and IR over 25?years before the development of diabetes are associated with unfavorable differences in LV structure and diastolic function beyond single values of FG and IR.

SUBMITTER: Bancks MP

PROVIDER: S-EPMC6451883 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Fasting glucose and insulin resistance trajectories during young adulthood and mid-life cardiac structure and function.

Bancks Michael P MP Carnethon Mercedes R MR Chow Lisa S LS Gidding Samuel S SS Jacobs David R DR Kishi Satoru S Lima Joao J Lloyd-Jones Donald D Reis Jared P JP Schreiner Pamela J PJ Zmora Rachel R Allen Norrina B NB

Journal of diabetes and its complications 20190206 5

<h4>Aims</h4>We assessed whether fasting glucose (FG) and insulin resistance (IR) trajectories during young adulthood are associated with changes in cardiac structure and function.<h4>Methods</h4>We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (baseline: 1985-1986). Echocardiography was performed after 25 (Y25) and 30 years of follow-up. Group-based modeling was used to determine 25-year trajectories in FG and IR. We assessed differences at Y25 and 5-year lo ...[more]

PMID: 30885553

Similar Datasets

Project description:Aims/hypothesisThe aim of this study was to determine whether long-term intra-individual variability in fasting glucose (FG) during young adulthood is associated with incident diabetes, cardiovascular disease (CVD) and mortality.MethodsWe included participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study, ages 18-30 years at baseline (1985-1986) and followed with eight examinations for up to 30 years. Long-term glucose variability was assessed using the CV (CV-FG) and the absolute difference between successive FG measurements (average real variability; ARV-FG). For participants who developed any event (diabetes, CVD or mortality), FG variability measurement was censored at the examination prior to event ascertainment. We estimated HRs for incident diabetes, CVD and mortality with adjustment for demographics, baseline FG, change in FG (censor - baseline) and time-varying education, smoking, alcohol consumption, BMI, physical activity, systolic BP, BP medications, LDL-cholesterol and cholesterol medications (and incident diabetes and diabetes medications for CVD and mortality outcomes).ResultsAmong 3769 black and white participants, there were 317 incident diabetes cases (102,677 person-years), 159 incident CVD events (110,314 person-years) and 174 deaths (111,390 person-years). After adjustment, HRs per 1 SD higher ARV-FG were 1.64 (95% CI 1.52, 1.78) for diabetes, 1.15 (95% CI 1.01, 1.31) for CVD and 1.25 (95% CI 1.11, 1.40) for mortality. The HRs per 1 SD higher CV-FG were 1.39 (95% CI 1.21, 1.58) for diabetes, 1.32 (95% CI 1.13, 1.54) for CVD and 1.08 (95% CI 0.92, 1.27) for mortality, after adjustment. The cause-specific HRs per 1 SD higher ARV-FG were 1.29 (95% CI 1.14, 1.47) for non-CVD death and 1.05 (95% CI 0.76, 1.45) for CVD death. We did not observe evidence for effect modification of any association by sex or race.Conclusions/interpretationOur results suggest that higher intra-individual FG variability during young adulthood before the onset of diabetes is associated with incident diabetes, CVD and mortality.

Project description:BACKGROUNDElevated circulating branched chain amino acids (BCAAs), measured at a single time point in middle life, are strongly associated with an increased risk of developing type 2 diabetes mellitus (DM). However, the longitudinal patterns of change in BCAAs through young adulthood and their association with DM in later life are unknown.METHODSWe serially measured BCAAs over 28 years in the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective cohort of apparently healthy Black and White young adults at baseline. Trajectories of circulating BCAA concentrations from years 2-30 (for prevalent DM) or years 2-20 (for incident DM) were determined by latent class modeling.RESULTSAmong 3,081 apparently healthy young adults, trajectory analysis from years 2-30 revealed 3 distinct BCAA trajectory groups: low-stable (n = 1,427), moderate-stable (n = 1,384), and high-increasing (n = 270) groups. Male sex, higher body mass index, and higher atherogenic lipid fractions were more common in the moderate-stable and high-increasing groups. Higher risk of prevalent DM was associated with the moderate-stable (OR = 2.59, 95% CI: 1.90-3.55) and high-increasing (OR = 6.03, 95% CI: 3.86-9.43) BCAA trajectory groups in adjusted models. A separate trajectory group analysis from years 2-20 for incident DM after year 20 showed that moderate-stable and high-increasing trajectory groups were also significantly associated with higher risk of incident DM, after adjustment for clinical variables and glucose levels.CONCLUSIONBCAA levels track over a 28-year span in most young adults, but serial clinical metabolomic measurements identify subpopulations with rising levels associated with high risk of DM in later life.FUNDINGThis research was supported by the NIH, under grants R01 HL146844 (JTW) and T32 HL069771 (MRC). The CARDIA study is conducted and supported by the NIH National Heart, Lung, and Blood Institute in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), the University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I).

Project description:ImportanceElevated non-high-density lipoprotein cholesterol (non-HDL-C) is associated with the presence of coronary artery calcification (CAC), a marker of heart disease in adulthood. However, the relative importance of non-HDL-C levels at specific life stages for CAC remains unclear.ObjectiveTo identify the relative association of non-HDL-C measured at distinct life stages (adolescence, young adulthood, mid-adulthood) with the presence of CAC measured in mid-adulthood.Design, setting, and participantsThe Cardiovascular Risk in Young Finns Study is a population-based prospective cohort study that started in 1980 with follow-up over 28 years. Participants from 3 population centers (Kuopio, Tampere, and Turku in Finland) represent a convenience sample drawn from the 3 oldest cohorts at baseline (aged 12-18 years in 1980). Data were collected from September 1980 to August 2008. Analysis began February 2020.ExposuresNon-HDL-C levels were measured at 3 life stages including adolescence (aged 12-18 years), young adulthood (aged 21-30 years), and mid-adulthood (aged 33-45 years).Main outcomes and measuresIn 2008, CAC was determined from computed tomography and dichotomized as 0 (no CAC, Agatston score = 0) and 1 (presence of CAC, Agatston score ≥1) for analysis. Using a bayesian relevant life course exposure model, the relative association was determined between non-HDL-C at each life stage and the presence of CAC in mid-adulthood.ResultsOf 589 participants, 327 (56%) were female. In a model adjusted for year of birth, sex, body mass index, systolic blood pressure, blood glucose level, smoking status, lipid-lowering and antihypertensive medication use, and family history of heart disease, cumulative exposure to non-HDL-C across all life stages was associated with CAC (odds ratio [OR], 1.50; 95% credible interval [CrI], 1.14-1.92). At each life stage, non-HDL-C was associated with CAC and exposure to non-HDL-C during adolescence had the strongest association (adolescence: OR, 1.16; 95% CrI, 1.01-1.46; young adulthood: OR, 1.14; 95% CrI, 1.01-1.43; mid-adulthood: OR, 1.12; 95% CrI, 1.01-1.34).Conclusions and relevanceThese data suggest that elevated non-HDL-C levels at all life stages are associated with coronary atherosclerosis in mid-adulthood. However, adolescent non-HDL-C levels showed the strongest association with the presence of CAC in mid-adulthood, and greater awareness of the importance of elevated non-HDL-C in adolescence is needed.

Dataset Information

Fasting glucose and insulin resistance trajectories during young adulthood and mid-life cardiac structure and function.

Publications

Fasting glucose and insulin resistance trajectories during young adulthood and mid-life cardiac structure and function.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets