OBJECTIVES To delineate the impact of diabetes mellitus (DM) on the development of cardiovascular diseases in a community population. PATIENTS & METHODS Cross-sectional survey of residents randomly selected through the Rochester Epidemiology Project, 45 years or older, of Olmsted County as of June 1, 1997, through September 30, 2000. Responders (2042) underwent assessment of systolic and diastolic function using echocardiography. The current analyses included all participants with DM and were compared with a group of participants without DM matched 1:2 for age, sex, hypertension, and coronary artery disease. Baseline characteristics and laboratory and echocardiography findings between groups were compared along with rates of mortality due to various cardiovascular conditions. RESULTS We identified 116 participants with DM and 232 matched participants without DM. Those with DM had a higher body mass index and plasma insulin and serum glucose levels. Although left ventricular ejection fractions were similar, E/e' ratio (9.7 vs 8.5; P=.001) was higher in DM vs non-DM. During a follow-up of 10.8 (interquartile range, 7.8-11.7) years, participants with DM had a higher incidence of heart failure (HF); hazard ratio, 2.1; 95% confidence limits, 1.2-3.6; P=.01) and 10-year Kaplan-Meier rate of 21% (22 of 116) vs 12% (24 of 232) compared with those without DM. We also examined the subgroup of participants without diastolic dysfunction. In this subgroup, those with DM had an increased risk for HF; hazard ratio, 2.5; 95% confidence limits, 1.0-6.3; P=.04). CONCLUSION In this cohort, participants with DM have an increased incidence of HF over a 10-year follow-up period even in the absence of underlying diastolic dysfunction. These findings suggest that DM is an independent risk factor for the development of HF and supports the concept of DM cardiomyopathy.

中文翻译：

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糖尿病是心力衰竭发展的独立预测因素：一项人口研究。


目的 描述糖尿病 (DM) 对社区人群心血管疾病发展的影响。患者和方法 对通过罗切斯特流行病学项目随机抽取的奥姆斯特德县 45 岁或以上居民进行横断面调查，调查时间为 1997 年 6 月 1 日至 2000 年 9 月 30 日。受访者 (2042) 使用以下方法接受了收缩和舒张功能评估：超声心动图。目前的分析包括所有患有糖尿病的参与者，并与一组没有糖尿病的参与者在年龄、性别、高血压和冠状动脉疾病方面进行了 1:2 匹配的比较。比较各组之间的基线特征、实验室和超声心动图检查结果以及各种心血管疾病引起的死亡率。结果 我们确定了 116 名患有 DM 的参与者和 232 名没有 DM 的匹配参与者。糖尿病患者的体重指数、血浆胰岛素和血糖水平较高。尽管左心室射血分数相似，但糖尿病患者的 E/e' 比率（9.7 比 8.5；P=0.001）高于非糖尿病患者。在 10.8 年（四分位距，7.8-11.7）年的随访期间，患有 DM 的参与者心力衰竭 (HF) 的发生率较高；危险比，2.1； 95% 置信限，1.2-3.6；与无 DM 的患者相比，10 年 Kaplan-Meier 率为 21%（116 人中的 22 人）和 12%（232 人中的 24 人）。我们还检查了没有舒张功能障碍的参与者亚组。在这个亚组中，患有糖尿病的人患心力衰竭的风险增加；危险比，2.5； 95% 置信限，1.0-6.3； P=.04)。结论 在该队列中，即使没有潜在的舒张功能障碍，糖尿病参与者在 10 年随访期内心力衰竭的发生率也有所增加。 这些发现表明，DM 是发生 HF 的独立危险因素，并支持 DM 心肌病的概念。