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

Citation

Wilmot EG, Leggate M, Khan JN, Yates T, Gorely T, Bodicoat DH, Khunti K, Kuijer JPA, Gray LJ, Singh A, Clarysse P, Croisille P, Nimmo MA, Mccann GP & Davies MJ (2014) Type 2 diabetes mellitus and obesity in young adults: The extreme phenotype with early cardiovascular dysfunction. Diabetic Medicine, 31 (7), pp. 794-798. https://doi.org/10.1111/dme.12431

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/m2 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.

Journal
Diabetic Medicine: Volume 31, Issue 7