Abstract 2998: Elevated Fasting Glucose in Non-Diabetic Persons is Associated with Increased Left Ventricular Mass and Wall Thickness in Women but Not Men: The Framingham Heart Study
INTRODUCTION: Elevated left ventricular (LV) mass and wall thickness (WT) are associated with excess cardiovascular morbidity and mortality. Diabetes and impaired glucose tolerance are associated with increased echocardiographic WT, but the relationship between elevated fasting glucose (EFG), in the absence of diabetes, and volumetric LV mass is not well characterized. We used cardiovascular magnetic resonance (CMR) to determine LV mass and WT in a longitudinally followed cohort strictly free of hypertension (SBP<140 mmHg, DBP<90 mmHg on all examinations), diabetes and clinical cardiovascular disease who were stratified by fasting glucose.
METHODS: 799 subjects (308 men) meeting the above entry criteria underwent CMR using an ECG-gated multislice SSFP sequence encompassing the LV in the short-axis orientation. Volumetric LV mass was determined using a ``Simpson’s rule” method of disks approach; septal (SWT) and inferolateral wall thicknesses (IWT) were measured from the short-axis slice just basal to the papillary muscle tips. EFG was a fasting glucose >100 mg/dl.
RESULTS: 300 subjects (134 women, 166 men) had EFG (101–125 mg/dL). EFG subjects were older (men: 62±8 vs. 60±8 years; women: 63±8 vs. 61±8, p<0.05 both) than non-EFG subjects. Women with EFG had greater LV mass and WT (Table⇓) and these differences persisted after adjustment for age and SBP, which was higher in EFG women (116±12 vs. 113±11 mmHg). LV concentricity, defined as RWT = IWT/LV end-diastolic radius, did not differ between EFG and non-EFG women. There were no differences in LV mass, WT or RWT between EFG and non-EFG men.
CONCLUSIONS: Elevated fasting glucose is associated with greater LV mass and WT in women; this association persists after indexation to height (HT) and allometric powers of height, and after adjustment for age and SBP. There was no association between EFG and LV mass or WT in men. The apparent gender-specific relationship between EFG and excess LV mass requires further investigation.