Glucose and insulin levels are associated with arterial stiffness and concentric remodeling of the heart

Abstract

BackgroundMortality attributable to heart failure remains high. The prevalence of heart failure in patients with diabetes mellitus ranges from 19 to 26%. It is estimated that up to 21.1 million adults in the United States have diagnosed diabetes mellitus and around 80.8 million have impaired fasting glucose. We investigated the associations of fasting glucose (FG) and fasting insulin (FI), the homeostasis model assessment-insulin resistance index (HOMA-IR) and 2-h postload glucose (2HG) and insulin (2HI) with parameters of left ventricular geometry and function and arterial stiffness determined by magnetic resonance imaging in individuals without diagnosed type 2 diabetes.MethodsCross-sectional analyses of 1001 individuals (453 women, 45.3%), aged 21 to 80 years, from two independent population-based studies, the Study of Health in Pomerania (SHIP-TREND-0) and KORA FF4 Study. FG, FI, HOMA-IR, 2HG and 2HI, as well as glucose tolerance categories, were analyzed for associations with heart and arterial parameters using multivariable-adjusted linear regression models.ResultsIn total, 390 individuals (39%) had prediabetes (isolated impaired fasting glucose, isolated glucose tolerance or both), and 49 (4.9%) were found to have unknown type 2 diabetes. In the multivariable-adjusted analysis, positive linear associations of FG, FI, HOMA-IR, 2HG and 2HI with arterial stiffness index and left ventricular wall-thickness and concentricity and inverse linear associations with left ventricular end-diastolic volume were observed. A 1 mmol/l higher FG was associated with a 1.18 ml/m2.7 (1.80 to 0.57; p < 0.001) lower left ventricular end-diastolic volume index, a 0.042 mm/m2.7 (0.014 to 0.070) higher left ventricular wall-thickness index, a 0.12 mmHg m2.7/ml (0.06 to 0.17; p < 0.001) greater arterial stiffness index and a 0.037 g/ml (0.018 to 0.056; p < 0.001) higher left ventricular concentricity.ConclusionsOur findings suggest that higher glucose levels in the prediabetic range and insulin resistance might lead to higher arterial stiffness and concentric remodeling of the heart.

Positive association between triglyceride glucose index and arterial stiffness in hypertensive patients: the China H-type Hypertension Registry Study

“…Although the exact mechanisms underlying the relationship of the TyG index with arterial stiffness is unclear, it may be linked to IR. IR is associated with hyperinsulinaemia, hyperglycaemia, dyslipidemia, hypertension and a proin ammatory state, as well as the effect of perturbed insulin signaling at the level of the intimal cells (endothelial cells, vascular smooth muscle cells, and macrophages), all of which predispose to arterial stiffness [13,[35][36][37][38]. In our study, men showed larger regression coe cients and odds ratios of the TyG index in relation with increased arterial stiffness than women.…”

Impacts of triglycerides-glucose index on prognosis of patients with type 2 diabetes mellitus and non-ST-segment elevation acute coronary syndrome: results from an observational cohort study in China

“…(2) Study have shown that FBG mainly re ects IR from liver, whereas fasting TGs mainly re ects IR from adipose cell [51]. Therefore, it can be concluded that TyG index may re ect IR from two aspects and thus be closely related to IR, which has been widely demonstrated to have signi cant relationship with endothelial dysfunction, oxidative stress, cardio-vascular remodeling, coagulation imbalance and in ammation response [52][53][54]. Indeed, a positive association between TyG index and hs-CRP levels was con rmed in the present study.…”

Investigation of Adiposity Measures and Operational Taxonomic unit (OTU) Data Transformation Procedures in Stool Samples from a German Cohort Study Using Machine Learning Algorithms

“…Nine adiposity measures were examined in this study: body mass index (BMI; kg/m 2 ), waist circumference (WC; cm), waist-hip ratio (WHR), waist-height ratio (WHtR), body adiposity index (BAI; according to the formula by Reference [23]: (hip circumference (cm))/((height (cm) × 0.01) 1.5 ) − 18), fat mass index (FMI; kg/m 2 ), lean body mass index (LBMI; kg/m 2 ), appendicular muscle mass index (AMMI; kg/m 2 ), and body fat (BF; %). Body composition was measured via bioelectrical impedance analysis (BIA 2000-S device, Data Input, Pöcking, Germany) with Kyle's equations [24][25][26][27]. To enable comparability of results, all adiposity measures were scaled to a mean of 0 and standard deviation of 1 for each (sub-)set for machine learning, separately.…”