Skip to main content
ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #319508

Research Project: Pediatric Clinical Nutrition

Location: Children's Nutrition Research Center

Title: Alterations in left ventricular, left atrial, and right ventricular structure and function to cardiovascular risk factors in adolescents with type 2 diabetes participating in the TODAY clinical trial

Author
item Levitt Katz, Lorraine - The Children'S Hospital Of Philadelphia
item Gidding, Samuel - Nemours Children'S Clinic
item Bacha, Fida - Children'S Nutrition Research Center (CNRC)
item Hirst, Kathryn - George Washington University
item Mckay, Siripoom - Texas Children'S Hospital
item Pyle, Laura - George Washington University
item Lima, Joao - Johns Hopkins University

Submitted to: Pediatric Diabetes
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/23/2013
Publication Date: 2/1/2015
Citation: Levitt Katz, L., Gidding, S.S., Bacha, F., Hirst, K., Mckay, S., Pyle, L., Lima, J.A. 2015. Alterations in left ventricular, left atrial, and right ventricular structure and function to cardiovascular risk factors in adolescents with type 2 diabetes participating in the TODAY clinical trial. Pediatric Diabetes. 16(1):39-47.

Interpretive Summary: Abnormalities in echocardiography in youth with type 2 diabetes (T2D) are not clear. We evaluated the results of echocardiograms of 455 adolescents with T2D from the Treatment Options for Type 2 Diabetes in Adolescents and Youth, or TODAY study. We found that youth with T2D have a high/normal left heart size (left ventricle mass or LVM) with some enlargement of the heart chamber in 16% of these adolescents. Determinants of higher LVM were male gender, black race, baseline and increasing body mass index (BMI), baseline and increasing systolic blood pressure (SBP), use of blood pressure (BP) medications, maintenance of glycemic control, and smoking; heart rate (HR) was inversely related to LVM. We concluded that adolescents with T2D have adverse measures of cardiac structure and function positively related to BMI and BP.

Technical Abstract: Data on cardiovascular disease (CVD) risk in adolescents with type 2 diabetes (T2D) are limited. Echocardiography was performed in the last year of the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial (median 4.5 yr from diagnosis of T2D, average age 18 yr), including MMode and 2D measurements of left ventricular (LV) and left atrial (LA) dimensions, LV tissue Doppler imaging (TDI), and tricuspid annular plane systolic excursion (TAPSE). Relationships between cardiac structure and function with demographic characteristics and baseline and change-from-baseline in CVD risk factors were examined in 455 participants. Mean LV mass (LVM) was high/normal and 16.2% had adverse LV geometry (8.1% concentric geometry, 4.5% LV hypertrophy, and 3.6% both). Determinants of higher LVM were male gender, black race, baseline and increasing body mass index (BMI), baseline and increasing systolic blood pressure (SBP), use of blood pressure (BP) medications, maintenance of glycemic control, and smoking; heart rate (HR) was inversely related. LV shortening fraction was high/normal and related to increasing BMI and higher baseline SBP. LV relative wall thickness was related to race-ethnicity, change in BMI, baseline glycated hemoglobin (HbA1c), and baseline and change in SBP. Mean LA internal dimension was high/normal and gender, baseline and increasing BMI, increasing SBP, and HR (inverse) were related. LV TDI was positively related to obesity (higher with adverse geometry). TAPSE was normal and related to higher baseline BMI and lower HR. There was no effect of T2D treatment on cardiac target organ injury. Adolescents with T2D have adverse measures of cardiac structure and function positively related to BMI and BP.