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Cardiac alterations present in prediabetes
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Adults with prediabetes may experience cardiac alterations, including decreased early to late diastolic atrial filling velocity ratio, increased left atrial volume and impaired spherical velocity compared with adults without prediabetes.
Francesco Purrello, MD, of the department of clinical and molecular biomedicine at the University Catania in Italy, and colleagues evaluated 106 adults with prediabetes defined by HbA1c (HbA1c, 5.7%-6.4% and normal fasting glucose/normal glucose tolerance) and 61 controls (HbA1c, < 5.7% and normal fasting glucose/normal glucose tolerance) to assess diastolic function and examine its association with markers of glycation and inflammation.
Fasting and 2-hour postload glycemia values were higher in participants with prediabetes compared with controls. Plasma uric acid levels and apolipoprotein B-to-apolipoprotein A1 ratio were also higher in participants with prediabetes compared with controls.
Participants with diabetes had higher plasma levels of endogenously secreted receptor for advanced glycation end-products (AGE; 0.41 ng/mL) compared with controls (0.56 ng/mL; P < .05) and slightly lower levels of soluble receptor for AGE (P < < .07).
Early to late diastolic atrial filling velocity ratio was lower in participants with prediabetes compared with controls (P < .05). Left atrium area (P < .05) and volume (P < .05) were larger and sphericity index (P < .05) higher in participants with prediabetes compared with controls.
Significant associations were observed between the early to late diastolic atrial filling velocity ratio and age (P < .005), BMI (P < .0001), total cholesterol (P < .02), LDL cholesterol (P < .05), HbA1c (P < .02), uric acid (P < .01), homeostasis model of assessment for insulin resistance (HOMA-IR; P < .02), high sensitivity C-reactive protein (P < .001), soluble receptor for AGE (P < .01) and endogenously secreted receptor for AGE (P < .02).
“Subjects with HbA1c prediabetes exhibited early subclinical cardiac alterations, such as lower early to late ventricular filling volumes ratio, higher left atrium volume and impaired sphericity index,” the researchers wrote. “In consideration of the expected increased use of HbA1c as a screening tool to identify individuals with alterations of glycemic homeostasis, these data may have important clinical implications to identify patients who are at increased risk for cardiovascular disease.” – by Amber Cox
Disclosure: The authors report no relevant financial disclosures.
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