Insulin Resistance is Linked to Adverse Cardiac Function Even Before Diabetes Development

Glucose intolerance and insulin resistance are associated with impaired cardiac function and structure, especially diastolic function, according to the results of a recent study.

In order to examine the relationship between glucose homeostasis and measures of cardiac structure and function, researchers conducted a study of 1818 Hispanic/Latino participants aged 45 years or older. Overall, 42% of participants had prediabetes and 28% had diabetes mellitus (47% of which was uncontrolled).
_________________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Going Paleo: Does it Improve Insulin Resistance in Obese Women?
Testosterone Therapy Improves Insulin Sensitivity in Type 2 Diabetes
_________________________________________________________________________________________________________________________________________________________________________

Prediabetes was defined as hemoglobin (HbA1c) ≥5.7 and <6.5% while diabetes mellitus was defined as fasting plasma glucose ≥126 mg/dL, 2-hour postload glucose ≥200 mg/dL, HbA1c ≥6.5%, or by hypoglycemic agent use. Uncontrolled diabetes mellitus was defined as HbA1c ≥7.0%. Insulin resistance was defined using the homeostatic model.

The researchers found that glucose intolerance was associated with increased left ventricular posterior wall and interventricular septal and relative wall thickness, reduced ejection fraction, reduced stroke and end-diastolic volumes, decreased peak E’ velocity, and increased E/E’ ratio.

Homeostatic model assessment of insulin resistance was associated with increased E/E’, greater relative wall thickness and septal thickness, lower stroke volume, and lower peak lateral septal E’ velocities.

“Glucose intolerance and insulin resistance are associated with unfavorable cardiac structure and function, particularly worsened measures of diastolic function, even before the development of diabetes mellitus,” the researchers concluded.

—Michael Potts

Reference:

Demmer RT, Allison MA, Cai J, et al. Association of impaired glucose regulation and insulin resistance with cardiac structure and function: results from ECHO-SOL (Echocardiographic Study of Latinos) [published online ahead of print October 11, 2016]. Circ Cardiovasc Imaging. doi: 10.1161/CIRCIMAGING.116.005032.