Glucose dysregulation and subclinical cardiac dysfunction in older adults: The Cardiovascular Health Study
Posted on 2022-06-21 - 16:06
Abstract 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.
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Garg, Parveen K.; Biggs, Mary L.; Kizer, Jorge R.; Shah, Sanjiv J.; Psaty, Bruce; Carnethon, Mercedes; et al. (2022): Glucose dysregulation and subclinical cardiac dysfunction in older adults: The Cardiovascular Health Study. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.6056549.v1
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Parveen K. Garg
Mary L. Biggs
Jorge R. Kizer
Sanjiv J. Shah
John S. Gottdiener
Kenneth J. Mukamal