Prediabetics at increased risk for structural heart disease and heart failure, study suggests
USA: People with prediabetes are more likely to suffer from structural heart disease and heart failure (HF), researchers report in a new study published in the journal Metabolic Syndrome and Related Disorders.
Prediabetes is a pre-diabetic condition when a person's blood sugar level is higher than normal, but not high enough to be considered diabetes. More than 470 million people worldwide are estimated to have prediabetes by 2030 and up to 70% of them will eventually develop type 2 diabetes.
In recent years, possible links between prediabetes and heart disease risk and death have become the focus of interest but the results have not been consistent and the term prediabetes remains controversial. Previous studies have shown prediabetes to be a novel risk factor associated recently with changes in the left ventricle. Leonardo Tamariz, Chen Neighborhood Medical Centers, Miller School of Medicine at the University of Miami, Miami, Florida, USA, and colleagues, therefore, aimed to determine if prediabetes is associated with heart failure and structural heart disease in a cross-sectional study.
For this purpose, the researchers performed screening echocardiograms on consecutive primary care patients. Hemoglobin A1c (HbA1c) was calculated within 3 months of the echocardiogram. The patients were classified as having normal glucose, low-risk or high-risk prediabetes, or diabetes.
Heart failure, defined as an ejection fraction (EF) <50%, and HF with preserved EF was the primary outcome of the study. Secondary outcome was structural heart disease defined as having either a large atrium, left ventricular hypertrophy, or low EF. The researchers included 15,056 patients who underwent a screening echocardiogram and had a recorded HbA1c.
The findings of the study were as follows:
- Only 2794 patients had normal blood glucose, 4201 had low-risk prediabetes, 2499 had high-risk prediabetes, and the remainder had diabetes.
- The adjusted odds ratio (ORs) of HF for low-risk prediabetes, high-risk prediabetes, and diabetes were 1.38, 1.47, and 1.60, respectively, when compared with normoglycemic patients.
- The adjusted OR of HF with preserved EF for low- and high-risk prediabetes and diabetes were 1.17, 1.60, and 1.63, respectively, when compared with normoglycemic patients.
The researchers conclude, "Prediabetes is a prevalent condition associated with structural heart disease and HF."
Reference:
Reyan Ghany, Leonardo Tamariz, Gordon Chen, Elissa Dawkins, Emancia Forbes, Thiago Tajiri, and Ana Palacio.Impact of Prediabetes on Cardiac Function Among Primary Care Patients.Metabolic Syndrome and Related Disorders.ahead of printhttp://doi.org/10.1089/met.2021.0006
