학술논문
Cardiac Biomarkers in Youth with Type 2 Diabetes Mellitus: Results from the TODAY Study
Document Type
Academic Journal
Author
Gidding, Samuel S.; Bacha, Fida; Bjornstad, Petter; Katz, Lorraine E. Levitt; Levitsky, Lynne L.; Lynch, Jane; Tryggestad, Jeanie B.; Weinstock, Ruth S.; El ghormli, Laure; Lima, Joao A.C.; McKay, S.; Haymond, M.; Anderson, B.; Bush, C.; Gunn, S.; Holden, H.; Jones, S. M.; Jeha, G.; McGirk, S.; Thamotharan, S.; Cuttler, L.; Abrams, E.; Casey, T.; Dahms, W.; Ievers-Landis, C.; Kaminski, B.; Koontz, M.; MacLeish, S.; McGuigan, P.; Narasimhan, S.; Geffner, M.; Barraza, V.; Chang, N.; Conrad, B.; Dreimane, D.; Estrada, S.; Fisher, L.; Fleury-Milfort, E.; Hernandez, S.; Hollen, B.; Kaufman, F.; Law, E.; Mansilla, V.; Miller, D.; Muñoz, C.; Ortiz, R.; Ward, A.; Wexler, K.; Xu, Y. K.; Yasuda, P.; Katz, Levitt L.; Berkowitz, R.; Boyd, S.; Johnson, B.; Kaplan, J.; Keating, C.; Lassiter, C.; Lipman, T.; McGinley, G.; McKnight, H.; Schwartzman, B.; Willi, S.; Arslanian, S.; Bacha, F.; Foster, S.; Galvin, B.; Hannon, T.; Kriska, A.; Libman, I.; Marcus, M.; Porter, K.; Songer, T.; Venditti, E.; Goland, R.; Gallagher, D.; Kringas, P.; Leibel, N.; Ng, D.; Ovalles, M.; Seidman, D.; Laffel, L.; Goebel-Fabbri, A.; Hall, M.; Higgins, L.; Keady, J.; Malloy, M.; Milaszewski, K.; Rasbach, L.; Nathan, D. M.; Angelescu, A.; Bissett, L.; Ciccarelli, C.; Delahanty, L.; Goldman, V.; Hardy, O.; Larkin, M.; Levitsky, L.; McEachern, R.; Norman, D.; Nwosu, D.; Park-Bennett, S.; Richards, D.; Sherry, N.; Steiner, B.; Tollefsen, S.; Carnes, S.; Dempsher, D.; Flomo, D.; Whelan, T.; Wolff, B.; Weinstock, R.; Bowerman, D.; Bristol, S.; Bulger, J.; Hartsig, J.; Izquierdo, R.; Kearns, J.; Saletsky, R.; Trief, P.; Zeitler, P.; Abramson, N.; Bradhurst, A.; Celona-Jacobs, N.; Higgins, J.; Kelsey, M.; Klingensmith, G.; Nadeau, K.; Witten, T.; Copeland, K.; Boss, E.; Brown, R.; Chadwick, J.; Chalmers, L.; Chernausek, S.; Hebensperger, A.; Macha, C.; Newgent, R.; Nordyke, A.; Olson, D.; Poulsen, T.; Pratt, L.; Preske, J.; Schanuel, J.; Sternlof, S.; Lynch, J.; Amodei, N.; Barajas, R.; Cody, C.; Hale, D.; Hernandez, J.; Ibarra, C.; Morales, E.; Rivera, S.; Rupert, G.; Wauters, A.; White, N.; Arbeláez, A.; Jones, J.; Jones, T.; Sadler, M.; Tanner, M.; Timpson, A.; Welch, R.; Caprio, S.; Grey, M.; Guandalini, C.; Lavietes, S.; Rose, P.; Syme, A.; Tamborlane, W.; Hirst, K.; Edelstein, S.; Feit, P.; Grover, N.; Long, C.; Pyle, L.; Linder, B.; Marcovina, S. M.; Harting, J.; Shepherd, J.; Fan, B.; Marquez, L.; Sherman, M.; Wang, J.; Nichols, M.; Mayer-Davis, E.; Liu, Y.; Lima, J.; Gidding, S.; Puccella, J.; Ricketts, E.; Danis, R.; Domalpally, A.; Goulding, A.; Neill, S.; Vargo, P.; Wilfley, D.; Aldrich-Rasche, D.; Franklin, K.; Massmann, C.; O’Brien, D.; Patterson, J.; Tibbs, T.; Van Buren, D.; Palmert, M.; Ratner, R.; Dremaine, D.; Silverstein, J.
Source
The Journal of Pediatrics. Jan 01, 2018 192:86-92e5
Subject
Language
English
ISSN
0022-3476
Abstract
OBJECTIVES: To examine cardiac biomarkers over time in youth-onset type 2 diabetes, and relate serum concentrations to cardiovascular disease risk factors, and left ventricular structure and function. STUDY DESIGN: TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) was a multicenter randomized trial of 3 treatments including 521 participants with type 2 diabetes, aged 10-17 years, and with 2-6 years of follow-up. Participants were 36% male, obese, and ethnically diverse. Annual serum concentrations of brain natriuretic peptide, troponin, tumor necrosis factor (TNF)-α, receptors 1 and 2 were related to blood pressure, body mass index, hemoglobin A1c, and left ventricular ejection fraction, diastolic function, relative wall thickness, and mass. RESULTS: Elevated concentrations of brain natriuretic peptide (≥100 pg/mL), TNF-α (≥5.6 pg/mL) and troponin (≥0.01 ng/mL), were present in 17.8%, 18.3%, and 34.2% of the cohort, respectively, at baseline, and in 15.4%, 17.1%, and 31.1% at the end of the study, with wide variability over time, without persistence in individuals or clear relationship to glycemia or cardiovascular structure/function. TNF receptors concentrations were increased at baseline and not significantly different from end-of-study concentrations. Adverse echocardiographic measures were more likely in the highest TNF receptor tertile (all P < .05): higher left ventricular mass (39.3 ± 9.0 g/m), left atrial internal dimension (3.7 ± 0.4 cm) and E/Em ratio, a measure of diastolic dysfunction (6.2 ± 1.9). After adjustment for body mass index, these relationships were no longer significant. CONCLUSIONS: Elevated serum concentrations of cardiac biomarkers were common in youth with type 2 diabetes, but their clinical significance is unclear and will require further long-term study. TRIAL REGISTRATION: ClinicalTrials.gov NCT00081328.