The association of self-reported coronary heart disease with diabetes duration in Korea

BACKGROUND

This study aimed to investigate the association of diabetes duration with self-reported coronary heart disease (CHD) in Korea.

METHODS

Among data from 34,145 persons compiled in the third Korean National Health and Nutrition Examination Survey in 2005, laboratory test and nutritional survey data from 5,531 persons were examined. The participants were asked to recall a physician's diagnosis of CHD (angina or myocardial infarction).

RESULTS

Age- and sex-adjusted relative risk for CHD was 1.51 (95% confidence interval [CI], 0.64 to 3.59; not significant) for diabetes with duration of <1 year, 2.27 (95% CI, 1.14 to 4.54; P=0.020) for diabetes with a duration of 1 to 5 years, and 3.29 (95% CI, 1.78 to 6.08; P<0.001) for diabetes with a duration >5 years, compared with non-diabetes as a control. Even after adjusting for age, sex, current smoking status, waist circumference, hypertension, triglycerides, high density lipoprotein cholesterol, and fasting plasma glucose, relative risk for CHD was 2.87 (95% CI, 1.01 to 8.11; P=0.047) in diabetes with a duration of 6 to 10 years and 4.07 (95% CI, 1.73 to 9.63; P=0.001) in diabetes with duration of >10 years with non-diabetes as a control.

CONCLUSION

CHD prevalence increased with an increase in diabetes duration in Korean men and women. Recently detected diabetes (duration <1 year) was not significantly associated with CHD prevalence compared to non-diabetes. However, diabetes of a duration of >5 years was associated with an increase in CHD compared to non-diabetics after adjusting for several CHD risk factors.

Left ventricular function in children and adolescents with type 1 diabetes mellitus

Background and Objectives

Adult studies have reported that patients with diabetes mellitus (DM) show ultrastructural and functional myocardial deterioration. The aim of this study was to assess whether cardiac functional deterioration can be detected in pediatric patients with type I DM and whether or not a relatively short duration of DM and hyperglycemia influences cardiac function.

Subjects and Methods

Forty-seven children and adolescents with DM and 38 healthy subjects (control group) were enrolled. Glycosylated hemoglobin (HbA1c), DM-induced complications, and left ventricular (LV) function as assessed using conventional and unconventional echocardiography {tissue Doppler imaging (TDI) and vector velocity imaging (VVI)} were evaluated.

Results

The conventional echocardiographic parameters, with the exception of early peak mitral inflow velocity, the findings of pulsed wave TDI at the annular level, and regional ventricular function by VVI, were not significantly different between the two groups. Using the conventional and unconventional indices of systolic and diastolic function, no significant relationship was found between the duration of DM and the echocardiographic parameters. The deceleration time (DT) and E'/A' had an inverse correlation with HbA1c (p=0.042 and p=0.016, respectively).

Conclusion

Patients with DM in childhood and early adolescence rarely have insight on the significance of DM, and their diet is difficult to control. An alteration of myocardial function induced by DM may begin earlier than generally thought, and these changes are accelerated when glycemic control is poor. We recommend the early institution of close observation of patients with diabetes for alterations in cardiac function, in addition to other diabetic complications.