Depressed myocardial mechano-energetic efficiency in subjects with dysglycemia

• Published in: Diabetes research and clinical practice Vol. 177; p. 108883
• Main Authors: Vanessa Fiorentino, Teresa, Miceli, Sofia, Succurro, Elena, Sciacqua, Angela, Andreozzi, Francesco, Sesti, Giorgio
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.07.2021
• Subjects: 1h post-load glucose; Cardiac energetics; Cardiovascular disease; Impaired fasting glucose; Impaired glucose tolerance; Myocardial energetic efficiency; Prediabetes; Impaired fasting glucose; Cardiovascular disease; Myocardial energetic efficiency; 1h post-load glucose; Prediabetes; Impaired glucose tolerance; Cardiac energetics
• ISSN: 0168-8227; 1872-8227; 1872-8227
• DOI: 10.1016/j.diabres.2021.108883

Evidence indicate that 1 h post-load glucose levels (1hPG) ≥ 155 mg/dl identify amongst subjects with normal glucose tolerance (NGT) a new category of prediabetes (NGT 1 h-high). A compromised myocardial mechano-energetic efficiency (MEE) is associated with type 2 diabetes and predicts adverse cardiovascular outcomes. Herein, we explored the association between prediabetes conditions such as NGT 1 h-high, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and a decreased MEE. MEE was assessed by an echocardiography-derived measure in 1467 non-diabetic individuals subdivided according to their glucose tolerance: NGT and 1-hPG < 155 mg/dl (NGT 1 h-low, n = 617), NGT 1 h-high (n = 210), isolated IFG (n = 237), and IGT (n = 403). Subjects with NGT 1 h-high, isolated IFG, and IGT displayed a higher myocardial oxygen consumption, and a decreased MEE in comparison to NGT 1 h-low group. MEE was inversely related to male sex, age, body mass index, total cholesterol, triglycerides, fasting and post-load glucose and insulin, C reactive protein, and positively correlated with insulin sensitivity estimated by the Matsuda index. In a stepwise multivariate linear regression model including several cardio-metabolic risk factors, 1hPG was the major predictor of MEE. Subjects with NGT 1 h-high, isolated IFG, and IGT have a raised myocardial oxygen consumption and a reduced MEE.