Fasting glucose and insulin resistance trajectories during young adulthood and mid-life cardiac structure and function

Michael P. Bancks, Mercedes R. Carnethon, Lisa S. Chow, Samuel S. Gidding, David R. Jacobs, Satoru Kishi, Joao Lima, Donald Lloyd-Jones, Jared P. Reis, Pamela J. Schreiner, Rachel Zmora, Norrina B. Allen

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: We assessed whether fasting glucose (FG) and insulin resistance (IR) trajectories during young adulthood are associated with changes in cardiac structure and function. Methods: We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (baseline: 1985–1986). Echocardiography was performed after 25 (Y25) and 30 years of follow-up. Group-based modeling was used to determine 25-year trajectories in FG and IR. We assessed differences at Y25 and 5-year longitudinal change in cardiac structure and function after adjustment for demographics, cumulative exposure to traditional cardiovascular risk factors, and baseline FG or IR. Results: We identified five FG trajectory groups among 2414 individuals and three IR trajectory groups among 2358 individuals. Moderate-increasing FG trajectory was associated with lower lateral E′ velocity (difference: −0.9 cm/s, 95%CI: −0.3, −1.5) and with greater left ventricular (LV) mass index (difference: 2.7 g/m 2.7 , 95%CI: 0.7, 4.7) at Y30 compared to low-stable FG. High-increasing IR trajectory was associated with lower lateral E′ velocity and septal E′ velocity at Y30 compared to low-decreasing IR trajectory. Conclusions: Trajectories in FG and IR over 25 years before the development of diabetes are associated with unfavorable differences in LV structure and diastolic function beyond single values of FG and IR.

Original languageEnglish (US)
Pages (from-to)356-362
Number of pages7
JournalJournal of Diabetes and Its Complications
Volume33
Issue number5
DOIs
StatePublished - May 2019

Bibliographical note

Funding Information:
The authors thank the other investigators, the staff, and the participants of the CARDIA study for their valuable contributions. MPB was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health under Award Number T32HL069771 to conduct the current work. The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201300025C & HHSN268201300026C), Northwestern University (HHSN268201300027C), University of Minnesota (HHSN268201300028C), Kaiser Foundation Research Institute (HHSN268201300029C), and Johns Hopkins University School of Medicine (HHSN268200900041C). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005). The authors have no conflicts to disclose. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the NHLBI; the National Institutes of Health; or the U.S. Department of Health and Human Services.

Funding Information:
MPB was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health under Award Number T32HL069771 to conduct the current work. The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201300025C & HHSN268201300026C), Northwestern University (HHSN268201300027C), University of Minnesota (HHSN268201300028C), Kaiser Foundation Research Institute (HHSN268201300029C), and Johns Hopkins University School of Medicine (HHSN268200900041C). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005).

Funding Information:
MPB was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health under Award Number T32HL069771 to conduct the current work. The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham ( HHSN268201300025C & HHSN268201300026C ), Northwestern University ( HHSN268201300027C ), University of Minnesota ( HHSN268201300028C ), Kaiser Foundation Research Institute ( HHSN268201300029C ), and Johns Hopkins University School of Medicine ( HHSN268200900041C ). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005).

Keywords

  • Cardiac structure and function
  • Epidemiology
  • Fasting glucose
  • Insulin resistance
  • Trajectories

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