Xiong Zhenyu, Xie Peihan, Li Jiaying, Chen Zhi-Chong, Lin Yifen, Liu Menghui, Zhang Shaozhao, Zhong Xiangbin, Zhou Huimin, Zhuang Xiaodong, Liao Xinxue
Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China.
Front Cardiovasc Med. 2021 Sep 16;8:687054. doi: 10.3389/fcvm.2021.687054. eCollection 2021.
Glycemic variability was found associated with left ventricular structure and function in type 2 diabetes. But it is still unclear that whether the greater visit-to-visit fasting glucose (FG) variability in young adulthood among the community population is associated with cardiac function alteration and cardiac remodeling at midlife. The community-based prospective cohort study of Coronary Artery Risk in Young Adult (CARDIA) recruited young participants at the baseline age of 18-30 years during the period of 1985-1986 (Year 0). FG was measured at Year 0, 2, 10, 15, 20, and 25. The echocardiographic evaluation of cardiac structure and function was conducted at year 25. A total of 2,600 young adults mean (SD) aged at 24.9 years (3.6) of which 57.3% were women and 46.7% were African Americans had been included in the study. After multivariable adjusted, higher SD of mean FG (SD) is associated with lower early peak diastolic septal mitral annular velocity (e') (β [SE], -0.214 [0.080], < 0.01) and higher E/e' (β [SE], 0.307 [0.094], < 0.01), and higher coefficient of variation of the mean FG (CV) is also associated with lower e' (β [SE], -0.141[0.066], < 0.05) and higher E/e' (β [SE], 0.204 [0.078], < 0.01). The higher average real variation of mean FG (ARV) is associated with higher E/e' (β [SE], 0.178 [0.085], < 0.05) and higher left ventricular mass index (LVMI) (β [SE], 1.240 [0.618], < 0.05). The higher FG variability in young adulthood is associated with the subclinical change of left ventricular (LV) diastolic function at midlife.
在2型糖尿病中，血糖变异性与左心室结构和功能相关。但尚不清楚社区人群中青年期访视间空腹血糖（FG）变异性增大是否与中年时的心功能改变和心脏重塑有关。基于社区的青年成人冠状动脉风险前瞻性队列研究（CARDIA）在1985 - 1986年（第0年）招募了基线年龄为18 - 30岁的年轻参与者。在第0、2、10、15、20和25年测量FG。在第25年进行心脏结构和功能的超声心动图评估。共有2600名平均（标准差）年龄为24.9岁（3.6岁）的年轻成年人纳入研究，其中57.3%为女性，46.7%为非裔美国人。多变量调整后，平均FG的标准差（SD）较高与舒张早期二尖瓣环间隔峰值速度（e'）较低（β[标准误]，-0.214[0.080]，P<0.01）以及E/e'较高（β[标准误]，0.307[0.094]，P<0.01）相关，平均FG的变异系数（CV）较高也与e'较低（β[标准误]，-0.141[0.066]，P<0.05）和E/e'较高（β[标准误]，0.204[0.078]，P<0.01）相关。平均FG的平均实际变异（ARV）较高与E/e'较高（β[标准误]，0.178[0.085]，P<0.05）和左心室质量指数（LVMI）较高（β[标准误]，1.240[0.618]，P<0.05）相关。青年期较高的FG变异性与中年时左心室（LV）舒张功能的亚临床变化有关。
