Cardiac organ damage in individuals with dysglycemia identified by 1-hour plasma glucose

The IDF has recently released a position statement recommending the use of 1-hour plasma glucose (1-h PG) during an OGTT to diagnose intermediate hyperglycemia (IH) and type 2 diabetes (T2D). While increasing evidence suggests that individuals with 1-h PG HI exhibit cardiac organ damage evaluating left ventricular mass normalized by body surface area (LVM index [LVMI]) and myocardial mechano-energetic efficiency normalized by LV mass (MEEi), the question of whether subjects with T2D identified by 1-h PG levels have cardiac organ damage is still unsettled. To clarify this issue, LVMI and MEEi, measured by validated echocardiography-derived measures, were assessed in 1848 adults participating in the CATAnzaro MEtabolic RIsk factors (CATAMERI) study. The study population was stratified into three groups based on 1-h PG during an OGTT according to the IDF recommendations: normal group (1-h PG ≤155 mg/dL); IH group (1-h PG from 155 to 208 mg/dL); T2D group (1-h PG >209 mg/dL). Of the whole population, 908 (356 men and 552 women) subjects were in the normal group, 644 (339 men and 305 women) in the IH group, and 296 (182 men and 114 women) subjects had T2D. As compared with the normal group, individuals with either IH or T2D exhibited significantly higher values of LVMI (99.1±28, 110.1±30, and 115.0±29 g/m2, p<0.001, respectively), and a decrease in MEEi (0.41±0.11, 0.37±0.11, and 0.34±0.10 ml/sec*g-1, p<0.001, respectively) after adjustment for age, and sex. In a logistic regression analysis, both individuals with IH and T2D by 1-h PG criterion exhibited a significant age-adjusted increased risk of having LV hypertrophy (OR 1.24, 95%CI 1.01-1.55, and OR 1.43, 95%CI 1.08-1.19, respectively) than normal group. These data suggest that 1-h PG-based criteria for diagnosis of IH and T2D are equally able to capture individuals with cardiac organ damage as other criteria based on fasting plasma glucose and/or HbA1c.