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Association between glycosylated hemoglobin, left ventricular mass and aortic function in nondiabetic individuals with insulin resistance

Division of Cardiology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece, ¹ Divisions of Cardiology and ² Endocrinology, The Ohio State University, Columbus, Ohio, USA and ³ Center for Clinical Research, Foundation of Biomedical Research, Academy of Athens, Athens, Greece

(Correspondence should be addressed to D A Stakos; Email: dstakos{at}med.duth.gr)

Objective: An association between glycosylated hemoglobin (GHb) and cardiovascular mortality in nondiabetic individuals has recently been reported. Prompt detection of nondiabetic individuals with high-normal GHb and early cardiovascular involvement may be of value for preventive strategies. In this investigation, a possible relationship between GHb, aortic function and left ventricular (LV) mass in nondiabetic individuals has been studied.

Methods: A total of 263 nondiabetic African–Americans, aged 22–63 (mean 42 ± 8) years were studied. All individuals were first degree relatives of diabetic patients, had normal oral glucose tolerance test (2-h OGTT) and decreased peripheral action of insulin. LV diameters and mass (echocardiography); ascending and abdominal aortic distensibility (echocardiography, arterial pressure); pulse wave velocity (PWV; electrocardiography, Doppler); fasting glucose; GHb; insulin sensitivity index (S_I) and 2-h OGTT were measured. Multiple linear and logistic regression analyses were used to identify significant independent associations of fasting glucose; GHb; S_I and 2-h OGTT with aortic function and LV mass.

Results: In fully adjusted multivariate logistic regression analysis, GHb predicted lower values of aortic distensibility (odds ratio (OR) 1.67 95% CI (1.04–2.75), P=0.04); higher PWV (OR 1.79 95% CI (1.09–2.93), P=0.022); and higher values of LV mass (OR 1.56 95% CI (1.08–2.88), P=0.029). Fasting glucose, S_I, and 2 h OGTT were not associated with aortic function and LV mass.

Conclusion: Higher GHb concentrations, even within ‘normal’ range, are independently associated with stiffer aorta and increased LV mass and thus may detect nondiabetic individuals at increased cardiovascular risk.