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Wednesday, October 29, 2014

DM and sub-clinical Myocardial Damage

  • Original Article
    • Epidemiology and Prevention

Diabetes Mellitus, Prediabetes, and Incidence of Subclinical Myocardial Damage

  1. From the Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (E.S., M.L., Y.C., L.S., J.W.M., A.R.S., J.C.); Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD (E.S., M.L., J.R., J.C.); Department of Medicine, Baylor College of Medicine and Methodist DeBakey Heart and Vascular Center, Houston, TX (R.C.H., C.M.B.).
  1. Correspondence to Elizabeth Selvin, PhD, MPH, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 E Monument St, Suite 2–600, Baltimore, MD 21287. E-maileselvin@jhu.edu

Abstract

Background—Persons with prediabetes and diabetes mellitus are at high risk for cardiovascular events. However, the relationships of prediabetes and diabetes mellitus to the development of subclinical myocardial damage are unclear.
Methods and Results—We measured cardiac troponin T with a highly sensitive assay (hs-cTnT) at 2 time points, 6 years apart, among 9051 participants of the community-based Atherosclerosis Risk in Communities Study with no diabetes mellitus, or prediabetes, and without cardiovascular disease including silent myocardial infarction by ECG. First, we examined the incidence of elevated hs-cTnT (≥14 ng/L) at 6 years of follow-up. Second, we examined clinical outcomes during the subsequent ≈14 years of follow-up among persons with and without incident elevations in hs-cTnT. Cumulative probabilities of elevated hs-cTnT at 6 years among persons with no diabetes mellitus, prediabetes, and diabetes mellitus were 3.7%, 6.4%, and 10.8%, respectively. Compared with normoglycemic persons, the adjusted relative risks for incident elevated hs-cTnT were 1.40 (95% CI, 1.08–1.80) for prediabetes and 2.47 (95% CI, 1.78–3.43) for diabetes mellitus. Persons with diabetes mellitus and incident elevations in hs-cTnT were at a substantially higher risk of heart failure (hazard ratio, 6.37 [95% CI, 4.27–9.51]), death (hazard ratio, 4.36 [95% CI, 3.14–6.07]), and coronary heart disease (hazard ratio, 3.84 [95% CI, 2.52–5.84]) compared with persons without diabetes mellitus and no incident elevation in hs-cTnT.
Conclusions—Prediabetes and diabetes mellitus were independently associated with the development of subclinical myocardial damage, as assessed by hs-cTnT, and those persons with evidence of subclinical damage were at highest risk for clinical events. These results support a possible deleterious effect of hyperglycemia on the myocardium, possibly reflecting a microvascular cause.

Cocoa and Memory


Small study suggests supplement may support memory in aging
New research found that a dietary intervention of flavanols extracted from cocoa beans may improve function in a region of the brain associated with memory. The small study (only 37 participants) showed that after three months of consuming a high-flavanol diet, participants with the typical memory of a 60-year-old improved their memory to that of a 40-year-old. Large-scale, long-term studies are needed before these findings can be generalized, and the researchers cautioned that the findings don’t mean the average person should consume more chocolate or cocoa to boost their memory. Almost all flavanols disappear when the beans are processed into chocolate. Flavanols are also in some teas, wine, fruits, vegetables and other plant species.

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Blau Souza

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SWEDEN-FACEBOOK-DATA-CENTER-SERVERS
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Sunday, October 26, 2014

2677 - AMICOR 17

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