Persistent Hyperglycemia and Insulin Resistance With the Risk of Worsening Cardiac Damage in Adolescents: A 7-Year Longitudinal Study of the Avon Longitudinal Study of Parents and Children (ALSPAC) Birth Cohort
Authors' conclusion
Persistent adolescent hyperglycemia and worsening IR were associated with the risk of worsening structural and functional cardiac damage, and these were largely explained by increased fat mass.
Study context
- Population
- Adolescents from the ALSPAC UK birth cohort, mean (SD) age 17.7 (0.4) years, with FPG, insulin and echocardiographic LVMI2.7 measured at baseline and at age 24 years
- Participants
- 1,595 adolescents
- Exposure
- Persistent hyperglycemia and worsening insulin resistance (IR) vs normal metabolic status, adolescence to young adulthood
- Outcome
- Progressive cardiac remodeling: LVMI2.7 and LV hypertrophy (LVMI2.7 ≥51g/m2.7)
- Follow-up
- 7 years
Methodological detailslongitudinal, birth cohort, 7-year follow-up
- Longitudinal
- Birth cohort
- 7-year follow-up
Main finding
As reported in the abstract
Each unit increase of glucose, increase in LVMI2.7
β 0.37 g/m2.7
95% CI 0.23–0.52P < 0.001
Each unit increase of HOMA-IR, increase in LVMI2.7 (0.63-1.57; P < 0.001)
1.10 g/m2.7
Persistent hyperglycemia ≥5.6 mmol/L, OR of worsening left ventricular (LV) hypertrophy
1.46
95% CI 1.35–1.47P < 0.001
Persistent hyperglycemia ≥6.1 mmol/L, OR of worsening LV hypertrophy
3.10
95% CI 1.19–8.08P = 0.021
Observational data: associations, not effects.
Further findings
Prevalence of LV hypertrophy · baseline to follow-up
- Baseline
- 2.4%
- Follow-up
- 7.1%
Mediation by fat mass of HOMA-IR–LVMI2.7 association
- Increased fat mass mediation
- 62%
Original publication
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