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葡萄糖代谢连续过程中的心脏结构与功能。

Cardiac structure and function across the continuum of glucose metabolism.

作者信息

Grönlund Tommi, Kaikkonen Kari, Junttila M Juhani, Ukkola Olavi, Kerkelä Risto, Huikuri Heikki V, Tulppo Mikko P

机构信息

Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland.

Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.

出版信息

Physiol Rep. 2025 Jun;13(12):e70429. doi: 10.14814/phy2.70429.

Abstract

Diabetes and prediabetes increase the risk of heart failure, but the relationship between glycated hemoglobin (HbA1c) and left ventricular systolic function in the general population is not known. This study aimed to investigate the relationship between HbA1c and global longitudinal strain (GLS) in nondiabetic and prediabetic subjects. A subpopulation of the Northern Finland Birth Cohort 1966 took part in a follow-up, including extensive medical examination and echocardiography (n = 1155), at the age of 46. The final study population included 636 healthy subjects. Normal HbA1c levels were divided into sex-specific tertiles and prediabetes, which were later pooled together. Univariate analysis after adjusted with covariates was used to compare cardiac function in HbA1c groups. HbA1c groups were defined as low (30.9 ± 1.7 mmol/mol, n = 190), medium (34.6 ± 1.0 mmol/mol, n = 189), high (37.4 ± 1.0 mmol/mol, n = 190) and prediabetes (41.0 ± 1.3 mmol/mol, n = 67) groups. Subjects with abnormal absolute GLS (<18) comprised 7.4%, 12.7%, 21.1%, and 17.9% (main effect p < 0.01) of low, medium, high HbA1c and prediabetes groups, respectively. HbA1c was not associated with any cardiac structure variables. High normal HbA1c levels and prediabetes are associated with reduced myocardial contractility in a healthy middle-aged population, potentially predicting the development of heart failure.

摘要

糖尿病和糖尿病前期会增加心力衰竭的风险,但在普通人群中糖化血红蛋白(HbA1c)与左心室收缩功能之间的关系尚不清楚。本研究旨在调查非糖尿病和糖尿病前期受试者中HbA1c与整体纵向应变(GLS)之间的关系。1966年芬兰北部出生队列的一个亚组在46岁时参加了一项随访,包括全面的医学检查和超声心动图检查(n = 1155)。最终的研究人群包括636名健康受试者。正常的HbA1c水平按性别分为三分位数和糖尿病前期,随后合并在一起。在校正协变量后进行单因素分析,以比较HbA1c组的心脏功能。HbA1c组定义为低(30.9±1.7 mmol/mol,n = 190)、中(34.6±1.0 mmol/mol,n = 189)、高(37.4±1.0 mmol/mol,n = 190)和糖尿病前期(41.0±1.3 mmol/mol,n = 67)组。绝对GLS异常(<18)的受试者分别占低、中、高HbA1c和糖尿病前期组的7.4%、12.7%、21.1%和17.9%(主效应p<0.01)。HbA1c与任何心脏结构变量均无关联。在健康中年人群中,正常高值的HbA1c水平和糖尿病前期与心肌收缩力降低有关,可能预示着心力衰竭的发生发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e4/12172345/77f082d49c51/PHY2-13-e70429-g002.jpg

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