Untreated diabetes mellitus, but not impaired fasting glucose, is associated with increased left ventricular mass and concentric hypertrophy in an elderly, healthy, Swedish population

Background/objectivesTo examine whether higher fasting plasma glucose (FPG) levels were independently associated with left ventricular (LV) mass and/or geometry in elderly, otherwise healthy subjects.MethodsWe tested cross-sectional associations between echocardiographically determined LV mass/geometric patterns, cardiovascular risk factors, and FPG categorized as normal fasting glucose (NFG), impaired fasting glucose (IFG), and untreated diabetes mellitus (DM), in 486 men and 207 women aged 56–79 years without overt cardiovascular disease, who received no cardiovascular, anti-diabetic, or lipid-lowering drugs and had a preserved LV ejection fraction > 50%.ResultsUnadjusted mean LV mass index (LVMI) was significantly greater among subjects with DM than those without (90 +/− 26 g/m2 vs. 85 +/− 20 g/m2, p = 0.01), as were both relative wall thickness (RWT) (0.43 +/− 0.09 vs. 0.40 +/− 0.08, p = 0.01) and prevalence of concentric LV hypertrophy (LVH) (11% vs. 6%, p = 0.03). However, only RWT remained significantly associated with the presence of DM after multivariable adjustment (p = 0.04). Interaction analyses revealed that greater LVMI/LVH was predominantly associated with higher levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) among subjects with IFG or DM, but not NFG.ConclusionsSubjects with untreated DM had higher values of LVMI and a greater prevalence of concentric LVH, but the associations were not independent of other risk factors. NT-proBNP was primarily associated with greater LV size in subjects with IFG or DM.