Background
Methods
Study population
Echocardiography
Laboratory analysis
Statistical analysis
Results
Patients characteristics
Variable | IR (+) | IR(-) | p-valuea | NGT | IGT | T2DM# | p-valuea |
---|---|---|---|---|---|---|---|
n (%)
| 38 (18) | 113 (54) | - | 64 (31) | 54 (26) | 90 (43) | - |
Variables
| |||||||
Age (years) | 62 (53-72) | 65 (56-72) | 0.604 | 62 (54-69) | 61 (51-70) | 71 (63-75) |
< 0.001*
|
Female sex, n (%) | 17 (45) | 53 (47) | 0.484 | 30 (46) | 23 (42) | 46 (51) | 0.606 |
WC (cm) | 103 (97-118) | 100 (92-111) |
0.031*
| 99 (90-110) | 100 (95-111) | 109 (98-117) |
< 0.001*
|
HC (cm) | 105 (98-114) | 99 (92-109) |
0.019*
| 100 (91-109) | 99 (95-110) | 109 (100-116) |
< 0.001*
|
BMI (kg/m2) | 28 (26-35) | 26 (24-30) |
0.001*
| 25 (24-30) | 26 (24-31) | 29 (26-32) |
< 0.001*
|
SBP, mmHg | 135 (128-142) | 130 (120-137) |
0.020*
| 128 (120-135) | 130 (126-140) | 136 (130-142) |
< 0.001*
|
DBP, mmHg | 80 (75-82) | 80 (70-82) | 0.863 | 80 (70-80) | 80 (74-84) | 80 (73-84) | 0.055 |
MAP (mmHg) | 96 (91-101) | 96 (90-100) | 0.258 | 94 (87-98) | 96 (91-101) | 98 (93-102) |
0.003*
|
Puls-Pressure | 57 (48-60) | 50 (42-58) |
0.031*
| 50 (41-58) | 52 (44-60) | 54 (50-61) |
0.005*
|
CV risk factors
| |||||||
HTN, n (%) | 33 (89) | 95 (84) | 0.319 | 49 (76) | 47 (89) | 84 (95) |
0.002*
|
HLP, n (%) | 23 (61) | 73 (64) | 0.396 | 37 (58) | 36 (67) | 62 (70) | 0.305 |
Smoker, n (%) | 2 (5) | 21 (19) |
0.037*
| 12 (19) | 10 (19) | 10 (12) | 0.366 |
Family Hx CAD | 24 (63) | 59 (52) | 0.162 | 29 (45) | 35 (64) | 42 (27) | 0.065 |
Hx Stroke, n (%) | 0 (0) | 4 (3) | 0.309 | 3 (5) | 1 (2) | 4 (4) | 0.674 |
Labaratory data
| |||||||
Fasting glucose | 100 (105-118) | 92 (86-98) |
< 0.001*
| 89 (84-94) | 104 (90-112) | 105 (98-118) |
< 0.001*
|
2h-PG (mg/dl) | 183 (138-233) | 132 (112-161) |
< 0.001*
| 117 (99-130) | 156 (139-164) | 225 (212-248) b |
< 0.001*
|
Insulin (μU/L) | 18.5 (15.7-24.0) | 5.0 (3.0-7.0) |
< 0.001*
| 5.0 (2.0-7.0) | 8.0 (5.0-15.0) | 9.5 (6.0-18.0) b |
< 0.001*
|
HOMA-IR | 5.09 (3.96-6.61) | 1.2 (0.69-1.77) |
< 0.001*
| 1.10 (0.44-1.56) | 1.86 (1.10-3.85) | 2.53 (1.62-4.78) b |
<0.001*
|
QUICKI | 0.30 (0.29-0.31) | 0.37 (0.35-0.40) |
<0.001*
| 0.38 (0.35-0.44) | 0.35 (0.31-0.38) | 0.33 (0.30-0.35) b |
0.001*
|
HbA1c (%) | 5.9 (5.7-6.3) | 5.7 (5.5-6.1) |
0.033*
| 5.7 (5.4-6.0) | 5.8 (5.6-6.1) | 6.6 (6.0-7.4) |
<0.001*
|
LDL-Ch (mg/dl) | 114 (99-136) | 109 (90-130) | 0.207 | 109 (92-136) | 115 (99-130) | 103 (77-130) | 0.095 |
HDL- Ch (mg/dl) | 49 (38-57) | 54 (4566) |
0.044*
| 54 (46-68) | 53 (47-63) | 46 (38-59) |
0.001*
|
Total- Ch (mg/dl) | 204 (177-222) | 191 (171-222) | 0.529 | 189 (175-228) | 200 (173-220) | 188 (63-221) | 0.300 |
Triglyceride | 142 (100-202) | 124 (90-169) | 0.234 | 120 (89-157) | 126 (95-165) | 162 (118-258) |
0.001*
|
Lipoprotein (a) | 13 (5-27) | 14 (5-39) | 0.729 | 11 (5-35) | 15 (4-38) | 5 (13-35) | 0.944 |
Creatinine (mg/dl) | 0.90 (0.80-1.20) | 0.89 (0.77-0.98) | 0.253 | 0.88 (0.75-0.96) | 0.90 (0.76-1.0) | 0.79 (0.90-1.05) | 0.643 |
hsCRP (mg/dl) | 0.2 (0.1-0.5) | 0.2 (0.1-0.6) | 0.961 | 0.2 (0.10-0.8) | 0.2 (0.1-0.45) | 0.3 (0.2-0.6) | 0.113 |
Variable | IR (+) | IR(-) | p-valuea | NGT | IGT | T2DM5# | p-valuea |
---|---|---|---|---|---|---|---|
n (%) | 38 (18) | 113 (54) | - | 64 (31) | 54 (26) | 90 (43) | - |
Glucose lowering treatment
| |||||||
Metformin, n (%) | 0 (0) | 1 (0.9) | 0.748 | 0 (0) | 1 (2) | 64 (71) |
<0.001*
|
Sulfonylurea, n (%) | 0 (0) | 1 (0.9) | 0.748 | 0 (0) | 0 (0) | 1 (1) |
<0.001*
|
Insulin therapy, n (%) | 0 (0) | 0 (0) | - | 0 (0) | 0 (0) | 24 (34) |
<0.001*
|
Thiazolidinediones, n (%) | 0 (0) | 0 (0) | - | 0 (0) | 0 (0) | 2 (2) | 0.266 |
Glinide, n (%) | 0 (0) | 0 (0) | - | 0 (0) | 0 (0) | 2 (2) | 0.266 |
Hypertension treatment
| |||||||
Beta-blocker, n (%) | 23 (61) | 72 (63) | 0.434 | 33 (52) | 39 (72) | 62 (69) |
0.033*
|
AT1 receptor blocker, n (%) | 5 (13) | 16 (14) | 1.000 | 9 (14) | 6 (11) | 15 (17) | 0.653 |
ACE-inhibitor, n (%) | 24 (36) | 65 (58) | 0.573 | 31 (48) | 37 (69) | 55 (61) | 0. 076 |
Calcium antagonist, n (%) | 7 (18) | 18 (16) | 0.801 | 9 (14) | 6 (11) | 23 (26) | 0.055 |
Diuretics, n (%) | 12 (32) | 31 (27) | 0.679 | 16 (25) | 16 (30) | 31 (34) | 0.450 |
Other Medications
| |||||||
Nitrate, n (%) | 5 (13) | 7 (6) | 0.181 | 1 (2) | 7 (13) | 16 (18) |
0.008*
|
Acetyl salicylic acid, n (%) | 24 (63) | 76 (68) | 0.691 | 38 (60) | 40 (74) | 65 (73) | 0.169 |
Clopidrogel, n (%) | 11 (29) | 34 (31) | 1.000 | 13 (21) | 18 (33) | 28 (32) | 0.259 |
Allopurinol, n (%) | 5 (13) | 6 (5.4) | 0.147 | 3 (5) | 3 (6) | 15 (17) |
0.022*
|
Aldosterone antagonist, n (%) | 1 (3) | 0 (0) | 0.248 | 0 (0) | 1 (2) | 0 (0) | 0.245 |
Statin, n (%) | 16 (42) | 60 (53) | 0.423 | 27 (42) | 28 (52) | 49 (55) | 0.598 |
Overall prevalence of diastolic dysfunction
Variable | IR (+) | IR(-) | p-valuea | NGT | IGT | T2DM5# | p-valuea |
---|---|---|---|---|---|---|---|
n | 38 (18) | 113 (54) | - | 64 (31) | 54 (26) | 90 (43) | - |
Diastolic function
| |||||||
Normal DF, n (%) | 3 (8) | 32 (28) | - | 24 (38) | 8 (15) | 6 (7) | - |
LVDD (any degree), n (%) | 35 (92) | 81 (72) |
0.013*
| 40 (63) | 46 (85) | 84 (93) |
0.001*
|
LVDD grade I, n (%) | 23 (60%) | 54 (48) |
0.015*
| 29 (45) | 34 (63) | 49 (54) |
0.001*
|
LVDD grade II, n (%) | 12 (32) | 27 (24) |
0.017*
| 11 (17) | 12 (22) | 35 (39) |
0.001*
|
IVS (mm) | 11(11-13) | 11 (10-13) | 0.378 | 11 (10-13) | 11 (10-13) | 12 (11-14) |
0.012*
|
Echocardiography
| |||||||
PLW (mm) | 12 (9-12) | 11 (10-13) | 0.617 | 11 (9-13) | 11 (10-13) | 12 (10-14) | 0.053 |
LVEDD (mm) | 47 (43-49) | 44 (40-48) | 0.084 | 45 (41-48) | 44 (40-49) | 44 (39-48) | 0.264 |
LVESD (mm) | 30 (27-35) | 30 (26-34) | 0.984 | 31 (28-36) | 29 (26-34) | 28 (24-33) |
0.037*
|
RWT | 0.48 (0.44-0.58) | 0.51 (0.43-0.62) | 0.625 | 0.49 (0.40-0.58) | 0.48 (0.44-0.59) | 0.53 (0.46-0.64) |
0.012*
|
LVM (g/m2) | 87 (68-109) | 84 (69-104) | 0.900 | 83 (69-100) | 84 (68-107) | 90 (69-111) | 0.430 |
LA- Index (ml/m2) | 31 (25-38) | 30 (24-36) | 0.555 | 28 (24-32) | 31 (25-37) | 32 (27-38) |
0.001*
|
EF biplan (%) | 70 (63-73) | 67 (62-71) | 0.119 | 65 (61-70) | 67 (63-73) | 67 (62-73) | 0.205 |
Smax (cm/s) | 6.40 (5.70-7.10) | 6.25 (5.50-7.15) | 0.883 | 6.3 (5.6-7.3) | 6.3 (5.4-7.0) | 6.0 (5.3-7.1) | 0.246 |
VE (cm/s) | 70 (60-80) | 60 (50-70) | 0.155 | 60 (50-70) | 60 (50-80) | 70 (60-90) |
0.012*
|
VA (cm/s) | 80 (60-90) | 70 (60-85) | 0.115 | 70 (55-85) | 70 (60-90) | 80 (70-90) |
<0.001*
|
VE/VA | 0.8 (0.7-1.1) | 0.9 (0.7-1.1) | 0.566 | 0.9 (0.8-1.2) | 0.9 (0.7-1.1) | 0.8 (0.7-1.1) | 0.218 |
E ' septal (cm/s) | 5.7 (4.7-7.1) | 6.1 (5.3-7.9) | 0.099 | 6.5 (5.3-8.2) | 6.2 (5.3-7.6) | 5.6 (4.9-6.6) |
0.001*
|
A ' (cm/s) | 9.2 (8.0-10.2) | 9.6 (8.4-10.4) | 0.644 | 9.7 (8.7-10.4) | 9.5 (8.6-10.4) | 9.0 (7.810.2) |
0.028*
|
E ' lateral (cm/s) | 8.3 (6.5-9.1) | 8.8 (7.0-10.6) | 0.085 | 9.4 (7.3-10.9) | 8.4 (6.6-10.2) | 7.7 (6.5-9.2) |
0.002*
|
Overage E' | 7.3 (5.4-7.9) | 7.5 (6.2-9.1) | 0.061 | 7.9 (6.3-9.5) | 7.3 (5.7-8.7) | 6.8 (5.6-7.8) |
<0.001*
|
E'/A' septal | 0.6 (0.5-0.8) | 0.7 (0.6-0.8) | 0.102 | 0.7 (0.6-0.8) | 0.7 (0.6-0.8) | 0.7 (0.5-0.7) | 0.087 |
E/E' septal | 11.3 (9.6-15.1) | 9.8 (7.7-12.7) |
0.014*
| 8.9 (7.3-11.9) | 10.2 (8.5-14.1) | 12.2 (9.6-15.3) |
<0.001*
|
Overage VE/E' | 9.8 (8.3-11.5) | 8.1 (6.6-11.0) |
0.011*
| 7.6 (6.2-10.1) | 8.8 (7.4-11.0) | 10.5 (8.1-13.2) |
<0.001*
|
PVsys (cm/s) | 59 (50-66) | 60 (51-67) | 0.380 | 59 (50-65) | 60 (51-68) | 60 (55-68) | 0.089 |
PVdia (cm/s) | 46 (38-53) | 43 (38-55) | 0.839 | 44 (39-54) | 43 (36-52) | 46 (40-55) | 0.468 |
PVsys/PVdia | 1.2 (1.1-1.5) | 1.3 (1.1-1.6) | 0.346 | 1.3 (1.1-1.5) | 1.4 (1.1-1.6) | 1.4 (1.1-1.6) | 0.325 |
PVa-max (cm/s) | 31 (25-34) | 31 (28-35) | 0.240 | 31 (28-35) | 31 (26-34) | 32 (28-35) | 0.382 |
GLS_Avg (-%) | 19.3 (21.8-17.0) | 19.5 (22.0-17.3) | 0.812 | 20 (22-18) | 19 (22-17) | 19 (21-17) | 0.363 |
Cardiac assessment
| |||||||
CAD, n (%) | 23 (60) | 62 (55) | 0.339 | 26 (41) | 37 (69) | 57 (64) |
0.003*
|
Hx. CABG | 1 (3) | 5 (5) | 0.437 | 2 (3) | 2 (4) | 8 (9) | 0.223 |
Hx. PTCA | 14 (37) | 46 (41) | 0.412 | 14 (22) | 28 (52) | 43 (49) |
0.001*
|
Hx. MI, n (%) | 10 (26) | 26 (23) | 0.416 | 7 (11) | 19 (35) | 16 (18) |
0.004*
|
NYHA (mean, SD) | 2.0 (± 0.61) | 1.9 (± 0.61) | 0.337 | 1.8 | 1.8 | 2.0 | 0.249 |
NT-pro-BNP (pg/ml) | (143 ± 105-228) | 131 (74-280) | 0.916 | 116 (65-123) | 126 (75-114) | 152 (80-417) | 0.283 |