The association of rate of weight gain during early adulthood with the prevalence of subclinical coronary artery disease in recently diagnosed type 2 diabetes: The MAXWEL-CAD study

Abstract

Objective: To investigate the association of the rate of weight gain (Rate max-wt) between the age of 20 years and the age of maximum lifetime weight gain with indicators of subclinical coronary artery disease (CAD) at the time of diagnosis of≥30 years with recently diagnosed (within 3 months) T2D and one or more cardiovascular risk factors to investigate the association of Rate max-wt with subclinical CAD. We used 64-slice cardiac computed tomography angiography to evaluate the degree of coronary artery stenosis, multivessel involvement, plaque characteristics, and coronary artery calcium score (CACS). Body weight at age 20 years (Wt20y) was obtained from participant records. Participants recalled their maximum weight (Wtmax) before T2D diagnosis and age at maximum weight (Age max-wt). The Rate max-wt was calculated as (Wt max-wt 20y) / (Age max-wt - 20 years). Results: The prevalence of coronary artery stenosis (≤50%), multivessel involvement (two or more vessels), plaque characteristics, and CACS <100 were 11.4%, 6.6%, 19.7%, and 12.8%, respectively. MeanWt20y andWt max were 60.1610.5 and 73.0611.5 kg, respectively. Mean Age max-wt was 41.3 6 10.7 years, and Rate max-wt was 0.59 6 0.56 kg/year. After adjusting for cardiovascular risk factors, including current BMI, the highest quarter of prior weight gain was significantly associated with coronary artery stenosis, multivessel involvement, and plaque characteristics, particularly mixed and noncalcified plaque. CONCLUSIONS: The findings suggest that a greater rate of prior weight gain may accelerate the development of subclinical vascular complications in patients with newly diagnosed T2D. © 2014 by the American Diabetes Association.