title: Cardiovascular characteristics in subjects with increasing levels of abnormal glucose regulation: the Strong Heart Study.
abstract: OBJECTIVE
  To evaluate whether impaired fasting glucose (IFG) or the combination of IFG and impaired glucose tolerance (IGT) is associated with progressive abnormalities of cardiac geometry and function.
  
  
  METHODS
  We studied 562 nondiabetic (311 women), nonhypertensive participants of the second Strong Heart Study exam, without prevalent cardiovascular (CV) disease and with estimated glomerular filtration rate ≥60 mL/min/1.73 m(2) (age 46-65 years, 198 with isolated IFG [35%], and 132 with combined IFG and IGT [23%]). Anthropometric parameters, insulin resistance, fibrinogen, C-reactive protein (CRP), lipid profile, blood pressure (BP), and echocardiographic parameters were compared with 232 participants with normal glucose tolerance (NGT).
  
  
  RESULTS
  BMI, prevalence of central obesity, homeostatic model assessment index of insulin resistance, plasma triglycerides, fibrinogen, and CRP increased progressively across categories of glucose intolerance (P < 0.0001), with the IFG+IGT group having higher values than those with isolated IFG (0.05 < P < 0.0001). Compared with NGT, both IFG and IFG+IGT exhibited greater left ventricular (LV) mass (P < 0.0001) and lower Doppler early peak rapid filling velocity to peak atrial filling velocity ratio (P < 0.005), without differences in LV systolic function. The odds of LV hypertrophy (LV mass index >46.7 in women or >49.2 g/m(2.7) in men) was 3.5 in IFG participants (95% CI 0.68-17.76; P = NS) and 9.76 (2.03-46.79; P = 0.004) in IFG+IGT, compared with NGT, after adjustment for age, sex, heart rate, systolic BP, and waist circumference (WC). In the overall sample, LV mass index was associated with WC (P = 0.033), CRP (P = 0.027), and 2-h oral glucose tolerance test (P = 0.001) independently of confounders.
  
  
  CONCLUSIONS
  Cardiometabolic profile and markers of inflammation are more severely altered in men and women with both IFG and IGT compared with those with IFG alone. These individuals, in the absence of hypertension, have a 10-fold greater probability of preclinical CV disease (LV hypertrophy).
authors.affiliation: Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. bcapaldo@unina.it
authors.forename: Brunella
authors.initials: B
authors.lastname: Capaldo
authors.forename: Procolo
authors.initials: P
authors.lastname: Di Bonito
authors.forename: Michele
authors.initials: M
authors.lastname: Iaccarino
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Roman
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
authors.forename: Gabriele
authors.initials: G
authors.lastname: Riccardi
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Simone
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D004452:Echocardiography; D005215:Fasting / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005947:Glucose; D018149:Glucose Intolerance / Q000097:blood; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D005340:Fibrinogen; D002097:C-Reactive Protein; D005947:Glucose