Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e008641 |
| Journal | Circulation. Cardiovascular imaging |
| Volume | 12 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2019 |
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Keywords
- blood glucose
- cardiovascular diseases
- female
- glycated hemoglobin A
- humans
- insulin resistance
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
Cite this
Glycemic Markers and Subclinical Cardiovascular Disease : The Jackson Heart Study. / Echouffo Tcheugui, Justin; Chen, Haiying; Kalyani, Rita R.; Sims, Mario; Simpson, Sean; Effoe, Valery S.; Correa, Adolfo; Bertoni, Alain G.; Golden, Sherita Hill.
In: Circulation. Cardiovascular imaging, Vol. 12, No. 3, 01.03.2019, p. e008641.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Glycemic Markers and Subclinical Cardiovascular Disease
T2 - The Jackson Heart Study
AU - Echouffo Tcheugui, Justin
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 Hill
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
UR - http://www.scopus.com/inward/record.url?scp=85063258057&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063258057&partnerID=8YFLogxK
U2 - 10.1161/CIRCIMAGING.118.008641
DO - 10.1161/CIRCIMAGING.118.008641
M3 - Article
C2 - 30879330
AN - SCOPUS:85063258057
VL - 12
SP - e008641
JO - Circulation: Cardiovascular Imaging
JF - Circulation: Cardiovascular Imaging
SN - 1941-9651
IS - 3
ER -