Serum insulin is associated with right ventricle function parameters and lung volumes in subjects free of cardiovascular disease

Abstract

Background: Diabetes mellitus is an established risk factor for cardiovascular diseases. Even impaired levels of glucose and insulin might harm organ function prior to diabetes onset. Whether serum glucose or insulin plays a direct role in cardiac dysfunction or lung volume reduction remains unclear. The aim was to investigate the relationship between glucose and insulin with the right ventricle and lung volumes within KORA-MRI FF4 study. Methods: From the KORA-MRI FF4 cohort study 337 subjects (mean age 55.7±9.1 years; 43% women) underwent a whole-body 3T MRI scan. Cardiac parameters derived from a cine-steady-state free precession sequence using cvi42. MRI-based lung volumes derived semi-automatically using an in-house algorithm. Fasting serum glucose, fasting insulin levels, and HOMA-index was calculated in all study subjects. Linear regression analyses performed to assess the relationships between glucose and insulin levels with right ventricle volumes and lung volumes adjusted for age, sex, BMI, and cardiovascular risk factors. Results: In univariate and multivariate-adjusted models, high serum insulin was associated with low end-diastolic volume (ß=–12.43, p<0.001), end-systolic volume (ß=–7.12, p<0.001), stroke volume (ß=–5.32, p<0.001), but not with ejection fraction. The association remained significant after additional adjustment for lung volumes. Similarly, serum insulin was inversely associated with lung volume (ß=–0.15, p=0.04). Sensitivity analysis confirmed results after excluding subjects with known diabetes. Conclusions: Serum insulin was inversely associated with right ventricle function and lung volumes in subjects from the general population free of cardiovascular disease, suggesting that increased insulin levels may contribute to subclinical cardiopulmonary circulation impairment.

Progressive right ventricular dysfunction and exercise impairment in patients with heart failure and diabetes mellitus: insights from the T.O.S.CA. Registry

“…Congruent with our results, serum insulin was inversely associated with right ventricle function and lung volumes in the general population suggesting that increased insulin levels may contribute to subclinical cardiopulmonary circulation impairment [25] in HF patients. In addition, when T2D patients were compared with regard to HbA1C levels, the RV-PA coupling resulted significantly more frequently impaired in patients with higher HbA1C levels, further pointing out the important role of hyperglycemia in HF.…”

Progressive right ventricular dysfunction and exercise impairment in patients with heart failure and diabetes mellitus: insights from the T.O.S.CA. Registry

“…Congruent with our results, serum insulin was inversely associated with right ventricle function and lung volumes in the general population suggesting that increased insulin levels may contribute to subclinical cardiopulmonary circulation impairment (23) in HF patients.…”

Association between Large Arteries Diameter and Heart Function in Subjects Free of Cardiovascular Diseases

“…Also, emphysema is related to increasing aortic diameters and aortic aneurysms [ 26 ]. In addition, we previously assessed the role of insulin and glucose on lung and RV volumes and found that higher insulin levels were associated with lower lung volumes and reduced volumetric RV performance [ 17 ].…”

“…The parameters for stroke volume and ejection fraction are composed of the difference between the end-systolic and end-diastolic volumes. pyHeart, dedicated in-house software that displays LV time-volume curves, was also used to quantify LV filling and ejection rates [ 17 , 18 ]. Peak gradients were predicted during systolic ejection, early LV filling (which is largely passive), and late LV filling (which is powered by atrial contraction) [ 19 ].…”