Heart Disease Risk In Diabetics Could Be Predicted By BMI
November 18, 2013

BMI Could Be Indicator Of Heart Disease Risk In Diabetics

redOrbit Staff & Wire Reports - Your Universe Online

A diabetic patient’s body mass index (BMI) could a simple but effective way to predict his or her risk of developing heart disease, according to research presented Sunday morning during the 2013 American Heart Association Scientific Sessions in Dallas.

Researchers from the Intermountain Medical Center Heart Institute, working alongside colleagues from Johns Hopkins University and the US National Institutes of Health (NIH), measured coronary artery plaque buildup in study participants and found that BMI was a “major controllable predictor of heart disease.”

The research is part of a larger study known as faCTor-64, which is a randomized trial specifically designed to determine whether or not CT scans can be effectively used to screen for heart disease in patients who have type-2 diabetes but do not have symptoms of heart disease. The authors of the study presented Sunday found that a patient’s risk for heart disease increases along with his or her BMI.

“Our study shows there's a strong linear relationship between BMI and plaque volume and composition,” explained Dr. J. Brent Muhlestein, the lead researcher and co-director of cardiovascular research at the Intermountain Medical Center Heart Institute. “So even being a little overweight is associated with more plaque, while being obese is associated with a lot of plaque.”

The scientists are calling the discovery “significant,” as heart disease reportedly causes 75 percent of deaths in patients who have diabetes. However, not all of those men and women have obvious risk factors, including smoking, high cholesterol or high blood pressure.

While those individuals who fall in the more obvious at-risk categories can  be treated, those without these indicators often do not realize they have heart disease until they suffer a cardiac event. Current methods of measuring plaque buildup are expensive, invasive, and not typically used on those who do not show signs of heart disease.

“It may be that in diabetic patients without any symptoms of heart disease, their BMI could be used to determine if they need a CT scan to screen for plaque buildup. We could then develop a treatment plan for at-risk patients,” Muhlestein said. The research could also change the way in which diabetic patients are treated.

Currently, managing the disease requires either medication that causes the body’s tissue to become more sensitive to glucose and decrease insulin production, insulin-stimulating therapy to increase the pancreas’ production of the substance, or insulin injections. However, these treatments often cause patients to gain weight.

“While weight gain does not necessarily predict heart disease in non-diabetics, the findings of this study shows that weight gain in diabetics can indicate the buildup of plaque,” the Intermountain Medical Center explained in a statement. “This is significant because the degree of weight gain can be reduced by using other types of diabetic treatments, such as insulin sensitizing medication.”

“Based on the findings of this study, choosing insulin sensitizing therapy, as the primary management strategy in diabetic patients may be beneficial by reducing the tendency towards elevated BMI's,” Dr. Muhlestein said. “Our goal… is to learn how to predict who will get heart disease, so we can provide the best care possible and improve long-term outcomes – rather than waiting until a person has a heart attack or even dies.”