Vanessa Fiorentino Teresa, Miceli Sofia, Succurro Elena, Sciacqua Angela, Andreozzi Francesco, Sesti Giorgio
Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy.
Department of Clinical and Molecular Medicine, University of Rome-Sapienza, Rome 00189, Italy.
Diabetes Res Clin Pract. 2021 Jul;177:108883. doi: 10.1016/j.diabres.2021.108883. Epub 2021 Jun 1.
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.
有证据表明，在糖耐量正常（NGT）的受试者中，负荷后1小时血糖水平（1hPG）≥155mg/dl可识别出一类新的糖尿病前期（NGT 1小时高血糖）。心肌机械能量效率（MEE）受损与2型糖尿病相关，并可预测不良心血管结局。在此，我们探讨了NGT 1小时高血糖、空腹血糖受损（IFG）和糖耐量受损（IGT）等糖尿病前期状况与MEE降低之间的关联。
通过超声心动图衍生指标评估1467名非糖尿病个体的MEE，这些个体根据糖耐量分为：NGT且1hPG<155mg/dl（NGT 1小时低血糖，n = 617）、NGT 1小时高血糖（n = 210）、单纯IFG（n = 237）和IGT（n = 403）。
与NGT 1小时低血糖组相比，NGT 1小时高血糖、单纯IFG和IGT的受试者心肌耗氧量更高，MEE降低。MEE与男性、年龄、体重指数、总胆固醇、甘油三酯、空腹及负荷后血糖和胰岛素、C反应蛋白呈负相关，与通过松田指数估计的胰岛素敏感性呈正相关。在包含多个心血管代谢危险因素的逐步多元线性回归模型中，1hPG是MEE的主要预测因子。
NGT 1小时高血糖、单纯IFG和IGT的受试者心肌耗氧量增加，MEE降低。
