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Glucose dysregulation and subclinical cardiac dysfunction in older adults: The Cardiovascular Health Study.
Wednesday,2022-07-20 20:41 America/Los_Angeles — ecterry
| Title | Glucose dysregulation and subclinical cardiac dysfunction in older adults: The Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2022 |
| Authors | Garg, PK, Biggs, ML, Kizer, JR, Shah, SJ, Psaty, B, Carnethon, M, Gottdiener, JS, Siscovick, D, Mukamal, KJ |
| Journal | Cardiovasc Diabetol |
| Volume | 21 |
| Issue | 1 |
| Pagination | 112 |
| Date Published | 2022 Jun 20 |
| ISSN | 1475-2840 |
| Keywords | Aged, Cross-Sectional Studies, Female, Glucose, Humans, Insulin Resistance, Male, Ventricular Dysfunction, Left, Ventricular Function, Left |
| Abstract | <p><b>OBJECTIVE: </b>We evaluated whether measures of glucose dysregulation are associated with subclinical cardiac dysfunction, as assessed by speckle-tracking echocardiography, in an older population.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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).</p><p><b>CONCLUSION: </b>In this cross-sectional study of older adults, associations of glucose dysregulation with subclinical cardiac dysfunction were largely attenuated after adjusting for central adiposity.</p> |
| DOI | 10.1186/s12933-022-01547-z |
| Alternate Journal | Cardiovasc Diabetol |
| PubMed ID | 35725477 |
| PubMed Central ID | PMC9210635 |
ePub date:
22/06