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Impaired fasting glucose and left ventricular diastolic dysfunction in middle-age adults: a retrospective cross-sectional analysis of 2971 subjects.
Cardiovasc Diabetol. 2015 Sep 15; 14:119.CD

Abstract

BACKGROUND

Left ventricular (LV) diastolic dysfunction (LVDD) is a well-established and early echocardiographic characteristic of diabetic cardiomyopathy. However, there are limited data on the association between impaired fasting glucose (IFG) and LVDD.

OBJECTIVE

To determine whether IFG is associated with LVDD among middle age adults.

METHODS

Amongst 3781 subjects screened in an annual health survey program and referred for an echocardiogram, 2971 individuals without LV systolic dysfunction or valvular heart disease were selected. Mean age of study population was 59 ± 12 years and 75% were men. The subjects were categorized into three groups: euglycemia (N = 2025), IFG (N = 534) and diabetes mellitus (DM; N = 412). Doppler echocardiography readers were blinded to glycemic state. Subjects with impaired LV relaxation, pseudo-normal or restrictive filling patterns were defined as having LVDD.

RESULTS

LVDD was diagnosed in 574 (19 %) of subjects and it was more prevalent among patients with IFG and DM than in euglycemic individuals (27, 30 and 15%, respectively; p < 0.001). Patients with IFG and DM had lower ratios of early (E) to late (A) trans-mitral flow (0.9 ± 0.3 and 0.9 ± 0.3 vs. 1.1 ± 0.4, respectively, p < 0.001). LV hypertrophy (LVH) was also more prevalent among patients with IFG and DM (11 and 18%, respectively, vs. 9%; p < 0.001). Multivariate binary logistic regression model adjusted to age, gender, obesity, LVH, renal function, total, high and low density lipoprotein cholesterol, triglycerides, ischemic heart disease, hypertension and LV ejection fraction showed that patients with IFG were 43% more likely to have LVDD compared with euglycemic subjects (95% confidence interval 1.12-1.83, p = 0.004).

CONCLUSIONS

IFG is independently associated with a significant increase in the likelihood for the presence of LVDD in middle aged adults.

Authors+Show Affiliations

Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel. assi_mil@hotmail.com. Department of Internal Medicine "E", Tel-Aviv Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel. assi_mil@hotmail.com.Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel. eladmaor@gmail.com. Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Ramat Gan, Israel. eladmaor@gmail.com.Department of Internal Medicine C, Chaim Sheba Medical Center, Ramat Gan, Israel. kivitys@gmail.com. Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Ramat Gan, Israel. kivitys@gmail.com. Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. kivitys@gmail.com.Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel. anat.berko@gmail.com.Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel. ssaaggiitt@yahoo.com. Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. ssaaggiitt@yahoo.com.Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Ramat Gan, Israel. alexander.tenenbasum@sheba.health.gov.il. Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. alexander.tenenbasum@sheba.health.gov.il. Cardiovascular Diabetology Research Foundation, Holon, Israel. alexander.tenenbasum@sheba.health.gov.il.Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. zfisman@post.tau.ac.il. Cardiovascular Diabetology Research Foundation, Holon, Israel. zfisman@post.tau.ac.il.Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel. aharon.erez@gmail.com.Institute for Medical Screening, Chaim Sheba Medical Center, Ramat Gan, Israel. shlomo.segev@sheba.health.gov.il.Department of Internal Medicine C, Chaim Sheba Medical Center, Ramat Gan, Israel. ysidi48@gmail.com. Department of Internal Medicine "E", Tel-Aviv Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel. ysidi48@gmail.com.Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel. ilan.goldenberg@sheba.health.gov.il. Department of Internal Medicine "E", Tel-Aviv Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel. ilan.goldenberg@sheba.health.gov.il.Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel. rafikupe@gmail.com. Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. rafikupe@gmail.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26369690

Citation

Milwidsky, Assi, et al. "Impaired Fasting Glucose and Left Ventricular Diastolic Dysfunction in Middle-age Adults: a Retrospective Cross-sectional Analysis of 2971 Subjects." Cardiovascular Diabetology, vol. 14, 2015, p. 119.
Milwidsky A, Maor E, Kivity S, et al. Impaired fasting glucose and left ventricular diastolic dysfunction in middle-age adults: a retrospective cross-sectional analysis of 2971 subjects. Cardiovasc Diabetol. 2015;14:119.
Milwidsky, A., Maor, E., Kivity, S., Berkovitch, A., Zekry, S. B., Tenenbaum, A., Fisman, E. Z., Erez, A., Segev, S., Sidi, Y., Goldenberg, I., & Kuperstein, R. (2015). Impaired fasting glucose and left ventricular diastolic dysfunction in middle-age adults: a retrospective cross-sectional analysis of 2971 subjects. Cardiovascular Diabetology, 14, 119. https://doi.org/10.1186/s12933-015-0282-4
Milwidsky A, et al. Impaired Fasting Glucose and Left Ventricular Diastolic Dysfunction in Middle-age Adults: a Retrospective Cross-sectional Analysis of 2971 Subjects. Cardiovasc Diabetol. 2015 Sep 15;14:119. PubMed PMID: 26369690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impaired fasting glucose and left ventricular diastolic dysfunction in middle-age adults: a retrospective cross-sectional analysis of 2971 subjects. AU - Milwidsky,Assi, AU - Maor,Elad, AU - Kivity,Shaye, AU - Berkovitch,Anat, AU - Zekry,Sagit Ben, AU - Tenenbaum,Alexander, AU - Fisman,Enrique Z, AU - Erez,Aharon, AU - Segev,Shlomo, AU - Sidi,Yechezkel, AU - Goldenberg,Ilan, AU - Kuperstein,Rafael, Y1 - 2015/09/15/ PY - 2015/08/22/received PY - 2015/08/27/accepted PY - 2015/9/16/entrez PY - 2015/9/16/pubmed PY - 2016/4/22/medline SP - 119 EP - 119 JF - Cardiovascular diabetology JO - Cardiovasc Diabetol VL - 14 N2 - BACKGROUND: Left ventricular (LV) diastolic dysfunction (LVDD) is a well-established and early echocardiographic characteristic of diabetic cardiomyopathy. However, there are limited data on the association between impaired fasting glucose (IFG) and LVDD. OBJECTIVE: To determine whether IFG is associated with LVDD among middle age adults. METHODS: Amongst 3781 subjects screened in an annual health survey program and referred for an echocardiogram, 2971 individuals without LV systolic dysfunction or valvular heart disease were selected. Mean age of study population was 59 ± 12 years and 75% were men. The subjects were categorized into three groups: euglycemia (N = 2025), IFG (N = 534) and diabetes mellitus (DM; N = 412). Doppler echocardiography readers were blinded to glycemic state. Subjects with impaired LV relaxation, pseudo-normal or restrictive filling patterns were defined as having LVDD. RESULTS: LVDD was diagnosed in 574 (19 %) of subjects and it was more prevalent among patients with IFG and DM than in euglycemic individuals (27, 30 and 15%, respectively; p < 0.001). Patients with IFG and DM had lower ratios of early (E) to late (A) trans-mitral flow (0.9 ± 0.3 and 0.9 ± 0.3 vs. 1.1 ± 0.4, respectively, p < 0.001). LV hypertrophy (LVH) was also more prevalent among patients with IFG and DM (11 and 18%, respectively, vs. 9%; p < 0.001). Multivariate binary logistic regression model adjusted to age, gender, obesity, LVH, renal function, total, high and low density lipoprotein cholesterol, triglycerides, ischemic heart disease, hypertension and LV ejection fraction showed that patients with IFG were 43% more likely to have LVDD compared with euglycemic subjects (95% confidence interval 1.12-1.83, p = 0.004). CONCLUSIONS: IFG is independently associated with a significant increase in the likelihood for the presence of LVDD in middle aged adults. SN - 1475-2840 UR - https://www.unboundmedicine.com/medline/citation/26369690/Impaired_fasting_glucose_and_left_ventricular_diastolic_dysfunction_in_middle_age_adults:_a_retrospective_cross_sectional_analysis_of_2971_subjects_ L2 - https://cardiab.biomedcentral.com/articles/10.1186/s12933-015-0282-4 DB - PRIME DP - Unbound Medicine ER -