AIMS Evidence indicate that 1h post-load glucose levels (1hPG)≥155 mg/dl identify amongst subjects with normal glucose tolerance (NGT) a new category of prediabetes (NGT 1h-high). A compromised myocardial mechano-energetic efficiency… Click to show full abstract
AIMS Evidence indicate that 1h post-load glucose levels (1hPG)≥155 mg/dl identify amongst subjects with normal glucose tolerance (NGT) a new category of prediabetes (NGT 1h-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 1h-high, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and a decreased MEE. METHODS 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 1h-low, n=617), NGT 1h-high (n=210), isolated IFG (n=237), and IGT (n=403). RESULTS Subjects with NGT 1h-high, isolated IFG, and IGT displayed a higher myocardial oxygen consumption, and a decreased MEE in comparison to NGT 1h-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. CONCLUSIONS Subjects with NGT 1h-high, isolated IFG, and IGT have a raised myocardial oxygen consumption and a reduced MEE.
               
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