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

Wilmot, E G; Leggate, M; Khan, J N; Yates, T; Gorely, T; Bodicoat, D H; Khunti, K; Kuijer, J P A; Gray, L J; Singh, A; Clarysse, P; Croisille, P; Nimmo, M A; McCann, G P; Davies, M. J.

doi:10.1111/dme.12431

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

Wilmot, E G; Leggate, M; Khan, J N; Yates, T; Gorely, T; Bodicoat, D H; Khunti, K; Kuijer, J P A; Gray, L J; Singh, A; Clarysse, P; Croisille, P; Nimmo, M A; McCann, G P; Davies, M. J.

Authors

E G Wilmot

Dr Mel Leggate M.Leggate@napier.ac.uk
Associate Professor

J N Khan

T Yates

T Gorely

D H Bodicoat

K Khunti

J P A Kuijer

L J Gray

A Singh

P Clarysse

P Croisille

M A Nimmo

G P McCann

M. J. Davies

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.

Citation

Wilmot, E. G., Leggate, M., Khan, J. N., Yates, T., Gorely, T., Bodicoat, D. H., Khunti, K., Kuijer, J. P. A., Gray, L. J., Singh, A., Clarysse, P., Croisille, P., Nimmo, M. A., McCann, G. P., & Davies, M. J. (2014). Type 2 diabetes mellitus and obesity in young adults: the extreme phenotype with early cardiovascular dysfunction. Diabetic medicine : a journal of the British Diabetic Association, 31(7), 794-798. https://doi.org/10.1111/dme.12431

Journal Article Type	Article
Acceptance Date	Mar 4, 2014
Online Publication Date	Mar 8, 2014
Publication Date	Jun 18, 2014
Deposit Date	Aug 1, 2016
Journal	Diabetic Medicine
Electronic ISSN	0742-3071
Publisher	Wiley
Peer Reviewed	Peer Reviewed
Volume	31
Issue	7
Pages	794-798
DOI	https://doi.org/10.1111/dme.12431
Keywords	Internal Medicine; Endocrinology, Diabetes and Metabolism; Endocrinology
Public URL	http://researchrepository.napier.ac.uk/Output/321281