TY - JOUR
T1 - Glycemic Markers and Subclinical Cardiovascular Disease
T2 - The Jackson Heart Study
AU - Echouffo-Tcheugui, Justin B.
AU - Chen, Haiying
AU - Kalyani, Rita R.
AU - Sims, Mario
AU - Simpson, Sean
AU - Effoe, Valery S.
AU - Correa, Adolfo
AU - Bertoni, Alain G.
AU - Golden, Sherita H.
N1 - Funding Information:
The JHS (Jackson Heart Study) is supported by contracts from the National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities and conducted in collaboration with Jackson State University (HHSN268201300049C and HHSN268201300050C), Tougaloo College (HHSN268201300048C), and the University of Mississippi Medical Center (HH-SN268201300046C and HHSN268201300047C). The study was funded by the following grant: 1R01HL117285-01. The funding agencies had no role in the formulation, editing, or decision to submit the manuscript for publication.
Publisher Copyright:
© 2019 American Heart Association, Inc.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background: We investigated the associations of glycemic markers (HbA1C [hemoglobin A1C], fasting plasma glucose, and insulin resistance - homeostasis model assessment of insulin resistance) with subclinical cardiovascular disease (CVD) among blacks. Methods: We included 4303 community-dwelling blacks (64% women; mean age, 54.5 years) without prevalent CVD. Subclinical CVD was defined as ≥1 of the following: any coronary artery calcification (CAC), elevated carotid intima-media thickness (cIMT), left ventricular (LV) hypertrophy, LV ejection fraction <50%, and peripheral artery disease (ankle-brachial index, <0.90). Estimates of cross-sectional associations of glycemic markers (fasting plasma glucose, HbA1C, and homeostasis model assessment of insulin resistance) with subclinical CVD measures were adjusted for traditional CVD risk factors. Results: Each 1% increment in HbA1C was associated with higher odds of CAC, abnormal cIMT, and subclinical CVD (all P <0.001). Adjusted mean values of LV mass (LVM), LVM index, relative wall thickness, CAC, and cIMT were increasingly abnormal with worsening HbA1C categories (all P<0.05). Each 10-mg/dL increase in fasting plasma glucose was associated with higher odds of LV hypertrophy, CAC, abnormal cIMT, and subclinical CVD (all P <0.005). Adjusted mean values of LVM, LVM index, relative wall thickness, CAC, ankle-brachial index, and cIMT were more abnormal across categories of worsening fasting plasma glucose (all P <0.05). Each unit increment in log-transformed homeostasis model assessment of insulin resistance conferred a higher odd of having LV hypertrophy (P<0.01). Across quartiles of homeostasis model assessment of insulin resistance, we observed progressively abnormal adjusted mean values of LVM, LVM index, relative wall thickness, and ankle-brachial index (all P <0.01). Conclusions: Among blacks, glycemic markers were differentially associated with various measures of subclinical CVD.
AB - Background: We investigated the associations of glycemic markers (HbA1C [hemoglobin A1C], fasting plasma glucose, and insulin resistance - homeostasis model assessment of insulin resistance) with subclinical cardiovascular disease (CVD) among blacks. Methods: We included 4303 community-dwelling blacks (64% women; mean age, 54.5 years) without prevalent CVD. Subclinical CVD was defined as ≥1 of the following: any coronary artery calcification (CAC), elevated carotid intima-media thickness (cIMT), left ventricular (LV) hypertrophy, LV ejection fraction <50%, and peripheral artery disease (ankle-brachial index, <0.90). Estimates of cross-sectional associations of glycemic markers (fasting plasma glucose, HbA1C, and homeostasis model assessment of insulin resistance) with subclinical CVD measures were adjusted for traditional CVD risk factors. Results: Each 1% increment in HbA1C was associated with higher odds of CAC, abnormal cIMT, and subclinical CVD (all P <0.001). Adjusted mean values of LV mass (LVM), LVM index, relative wall thickness, CAC, and cIMT were increasingly abnormal with worsening HbA1C categories (all P<0.05). Each 10-mg/dL increase in fasting plasma glucose was associated with higher odds of LV hypertrophy, CAC, abnormal cIMT, and subclinical CVD (all P <0.005). Adjusted mean values of LVM, LVM index, relative wall thickness, CAC, ankle-brachial index, and cIMT were more abnormal across categories of worsening fasting plasma glucose (all P <0.05). Each unit increment in log-transformed homeostasis model assessment of insulin resistance conferred a higher odd of having LV hypertrophy (P<0.01). Across quartiles of homeostasis model assessment of insulin resistance, we observed progressively abnormal adjusted mean values of LVM, LVM index, relative wall thickness, and ankle-brachial index (all P <0.01). Conclusions: Among blacks, glycemic markers were differentially associated with various measures of subclinical CVD.
KW - blood glucose
KW - cardiovascular diseases
KW - female
KW - glycated hemoglobin A
KW - humans
KW - insulin resistance
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U2 - 10.1161/CIRCIMAGING.118.008641
DO - 10.1161/CIRCIMAGING.118.008641
M3 - Article
C2 - 30879330
AN - SCOPUS:85063258057
VL - 12
JO - Circulation: Cardiovascular Imaging
JF - Circulation: Cardiovascular Imaging
SN - 1941-9651
IS - 3
M1 - e008641
ER -