Background-Whether diabetes mellitus (DM) adversely affects left ventricula
r (LV) structure and function independently of increases in body mass index
(BMI) and blood pressure is controversial.
Methods and Results-Echocardiography was used in the Strong Heart Study, a
study of cardiovascular disease in American Indians, to compare LV measurem
ents between 1810 participants with DM and 944 with normal glucose toleranc
e. Participants with DM were older (mean age, 60 versus 59 years), had high
er BMI (32.4 versus 28.9 kg/m(2)) and systolic blood pressure (133 versus 1
24 mm Hg), and were more likely to be female, to be on antihypertensive tre
atment, and to live in Arizona (all P<0.001). In analyses adjusted for cova
riates, women and men with DM had higher LV mass and wall thicknesses and l
ower LV fractional shortening, midwall shortening, and stress-corrected mid
wall shortening (all P<0.002), Pulse pressure/stroke volume, a measure of a
rterial stiffness, was higher in participants with DM (P<0.001 independent
of confounders).
Conclusions-Non-insulin-dependent DM has independent adverse cardiac effect
s, including increased LV mass and wall thicknesses, reduced LV systolic ch
amber and myocardial function, and increased arterial stiffness. These find
ings identify adverse cardiovascular effects of DM, independent of associat
ed increases in BMI and arterial pressure, that may contribute to cardiovas
cular events in diabetic individuals.