02773nas a2200349 4500008004100000022001400041245011200055210006900167260001600236300000800252490000700260520176200267653000902029653002802038653001102066653001202077653001102089653002302100653000902123653003402132653003102166100002102197700001902218700002002237700002002257700001702277700002402294700002402318700002102342700002402363856003602387 2022 eng d a1475-284000aGlucose dysregulation and subclinical cardiac dysfunction in older adults: The Cardiovascular Health Study.0 aGlucose dysregulation and subclinical cardiac dysfunction in old c2022 Jun 20 a1120 v213 a

OBJECTIVE: We evaluated whether measures of glucose dysregulation are associated with subclinical cardiac dysfunction, as assessed by speckle-tracking echocardiography, in an older population.

METHODS: Participants were men and women in the Cardiovascular Health Study, age 65+ years and without coronary heart disease, atrial fibrillation, or heart failure at baseline. We evaluated fasting insulin resistance (IR) with the homeostatic model of insulin resistance (HOMA-IR) and estimated the Matsuda insulin sensitivity index (ISI) and insulin secretion with an oral glucose tolerance test. Systolic and diastolic cardiac mechanics were measured with speckle-tracking analysis of echocardiograms. Multi-variable adjusted linear regression models were used to investigate associations of insulin measures and cardiac mechanics.

RESULTS: Mean age for the 2433 included participants was 72.0 years, 33.6% were male, and 3.7% were black. After adjustment for age, sex, race, site, speckle-tracking analyst, echo image and quality score, higher HOMA-IR, lower Matsuda ISI, and higher insulin secretion were each associated with worse left ventricular (LV) longitudinal strain and LV early diastolic strain rate (p-value < 0.005); however, associations were significantly attenuated after adjustment for waist circumference, with the exception of Matsuda ISI and LV longitudinal strain (increase in strain per standard deviation increment in Matsuda ISI = 0.18; 95% confidence interval = 0.03-0.33).

CONCLUSION: In this cross-sectional study of older adults, associations of glucose dysregulation with subclinical cardiac dysfunction were largely attenuated after adjusting for central adiposity.

10aAged10aCross-Sectional Studies10aFemale10aGlucose10aHumans10aInsulin Resistance10aMale10aVentricular Dysfunction, Left10aVentricular Function, Left1 aGarg, Parveen, K1 aBiggs, Mary, L1 aKizer, Jorge, R1 aShah, Sanjiv, J1 aPsaty, Bruce1 aCarnethon, Mercedes1 aGottdiener, John, S1 aSiscovick, David1 aMukamal, Kenneth, J uhttps://chs-nhlbi.org/node/9092