Glucose dysregulation and subclinical cardiac dysfunction in older adults: The Cardiovascular Health Study

Garg, Parveen K.; Biggs, Mary L.; Kizer, Jorge R.; Shah, Sanjiv J.; Psaty, Bruce; Carnethon, Mercedes; Gottdiener, John S.; Siscovick, David; Mukamal, Kenneth J.

doi:10.1186/s12933-022-01547-z

Cardiovascular Diabetology

Table 4 Effect of Model 2 covariates on glucose and insulin measure estimates (each covariate is added one at a time)

From: Glucose dysregulation and subclinical cardiac dysfunction in older adults: The Cardiovascular Health Study

Left ventricular longitudinal strain
Measure	Waist circumference	Systolic BP	BP medication	LDL cholesterol	HDL cholesterol	eGFR_cys	Heart rate	Smoking	Alcohol
	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)
	p-value	p-value	p-value	p-value	p-value	p-value	p-value	p-value	p-value
Fasting glucose	− 0.17 (− 0.31, − 0.03)	− 0.23 (− 0.37, − 0.09)	− 0.23 (− 0.37, − 0.10)	− 0.26 (− 0.39, − 0.12)	− 0.22 (− 0.36, − 0.08)	− 0.25 (− 0.39, − 0.12)	− 0.20 (− 0.33, − 0.06)	− 0.25 (− 0.39, − 0.12)	− 0.26 (− 0.39, − 0.12)
Fasting glucose	0.018	0.001	0.001	< 0.001	0.002	< 0.001	0.004	< 0.001	< 0.001
2-h glucose	− 0.15 (− 0.29, − 0.01)	− 0.20 (− 0.34, − 0.06)	− 0.21 (− 0.35, − 0.07)	− 0.23 (− 0.37, − 0.10)	− 0.20 (− 0.34, − 0.06)	− 0.23 (− 0.37, − 0.09)	− 0.17 (− 0.31, − 0.03)	− 0.23 (− 0.37, − 0.10)	− 0.24 (− 0.38, − 0.10)
2-h glucose	0.031	0.004	0.003	0.001	0.005	0.001	0.017	0.001	0.001
HOMA-IR	− 0.14 (− 0.27, − 0.01)	− 0.21 (− 0.34, − 0.09)	− 0.21 (− 0.34, − 0.08)	− 0.23 (− 0.36, − 0.10)	0.20 (− 0.32, − 0.07)	− 0.20 (− 0.33, − 0.07)	− 0.19 (− 0.32, − 0.07)	− 0.23 (− 0.36, − 0.11)	− 0.23 (− 0.36, − 0.10)
HOMA-IR	0.037	0.001	0.002	< 0.001	0.003	0.002	0.003	< 0.001	< 0.001
Matsuda ISI	0.29 (0.15, 0.44)	0.37 (0.23, 0.51)	0.38 (0.25, 0.52)	0.41 (0.27, 0.54)	0.36 (0.22, 0.50)	0.38 (0.25, 0.52)	0.35 (0.21, 0.48)	0.41 (0.28, 0.55)	0.41 (0.28, 0.55)
Matsuda ISI	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001
Stumvoll index	− 0.11 (− 0.25, 0.03)	− 0.21 (− 0.35, − 0.07)	− 0.20 (− 0.33, − 0.06)	− 0.21 (− 0.35, − 0.07)	− 0.17 (− 0.31, − 0.03)	− 0.19 (− 0.33, − 0.05)	− 0.21 (− 0.35, − 0.08)	− 0.22 (− 0.36, − 0.08)	− 0.21 (− 0.35, − 0.08)
Stumvoll index	0.122	0.003	0.006	0.002	0.016	0.008	0.002	0.002	0.002

Left ventricular early diastolic strain rate
Measure	Waist circumference	Systolic BP	BP medication	LDL cholesterol	HDL cholesterol	eGFR_cys	Heart rate	Smoking	Alcohol
	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)
	p-value	p-value	p-value	p-value	p-value	p-value	p-value	p-value	p-value
Fasting glucose	− 0.01 (− 0.02, − 0.00)	− 0.02 (− 0.02, − 0.01)	− 0.02 (− 0.02, − 0.01)	− 0.02 (− 0.03, − 0.01)	− 0.01 (− 0.02, − 0.01)	− 0.02 (− 0.03, − 0.01)	− 0.02 (− 0.03, − 0.01)	− 0.02 (− 0.03, − 0.01)	− 0.02 (− 0.03, − 0.01)
Fasting glucose	0.045	0.001	0.001	< 0.001	0.002	< 0.001	< 0.001	< 0.001	< 0.001
2-h glucose	− 0.01 (− 0.02, 0.00)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.00)
2-h glucose	0.146	0.015	0.012	0.003	0.012	0.004	0.006	0.003	0.003
HOMA-IR	− 0.01 (− 0.02, − 0.00)	− 0.02 (− 0.02, − 0.01)	− 0.01 (− 0.02, − 0.01)	− 0.02 (− 0.03, − 0.01)	− 0.01 (− 0.02, − 0.01)	− 0.01 (− 0.02, − 0.01)	− 0.02 (− 0.03, − 0.01)	− 0.02 (− 0.03, − 0.01)	− 0.02 (− 0.03, − 0.01)
HOMA-IR	0.041	< 0.001	0.001	< 0.001	0.001	0.001	< 0.001	< 0.001	< 0.001
Matsuda ISI	0.01 (0.00, 0.02)	0.02 (0.01, 0.03)	0.02 (0.01, 0.03)	0.03 (0.02, 0.04)	0.02 (0.01, 0.03)	0.02 (0.01, 0.03)	0.03 (0.02, 0.03)	0.03 (0.02, 0.04)	0.03 (0.02, 0.04)
Matsuda ISI	0.004	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001
Stumvoll index	− 0.01 (− 0.02, 0.00)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.01)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.00)	− 0.01 (− 0.02, − 0.01)	− 0.01 (− 0.02, − 0.01)	− 0.01 (− 0.02, − 0.00)
Stumvoll index	0.268	0.003	0.009	0.003	0.017	0.014	0.002	0.002	0.003

Left atrial reservoir strain
Measure	Waist circumference	Systolic BP	BP medication	LDL cholesterol	HDL cholesterol	eGFR_cys	Heart rate	Smoking	Alcohol
	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)	Beta (95% CI)
	p-value	p-value	p-value	p-value	p-value	p-value	p-value	p-value	p-value
Fasting glucose	− 0.40 (− 1.01, 0.22)	− 0.61 (− 1.21, 0.00)	− 0.64 (− 1.24, − 0.03)	− 0.65 (− 1.26, − 0.05	− 0.62 (− 1.23, − 0.01)	− 0.68 (− 1.28, − 0.07)	− 0.59 (− 1.20, 0.02)	− 0.68 (− 1.29, − 0.08)	− 0.67 (− 1.28, − 0.07)
Fasting glucose	0.210	0.049	0.040	0.034	0.047	0.028	0.056	0.027	0.029
2-h glucose	− 0.19 (− 0.82, 0.43)	− 0.39 (− 1.01, 0.23)	− 0.44 (− 1.06, 0.18)	− 0.46 (− 1.08, 0.15)	− 0.41 (− 1.03, 0.21)	− 0.47 (− 1.08, 0.14)	− 0.37 (− 0.99, 0.25)	− 0.49 (− 1.10, 0.13)	− 0.47 (− 1.08, 0.15)
2-h glucose	0.543	0.219	0.163	0.138	0.190	0.134	0.240	0.120	0.138
HOMA-IR	− 0.01 (− 0.60, 0.57)	− 0.27 (− 0.84, 0.29)	− 0.26 (− 0.84, 0.31)	− 0.33 (− 0.89, 0.24)	− 0.26 (− 0.83, 0.31)	− 0.28 (− 0.85, 0.29)	− 0.26 (− 0.83, 0.31)	− 0.33 (− 0.89, 0.24)	− 0.31 (− 0.88, 0.26)
HOMA-IR	0.965	0.343	0.366	0.257	0.375	0.333	0.367	0.259	0.283
Matsuda ISI	0.41 (− 0.24, 1.07)	0.75 (0.13, 1.38)	0.82 (0.19, 1.44)	0.82 (0.20, 1.44)	0.77 (0.14, 1.41)	0.83 (0.21, 1.46)	0.76 (0.14, 1.37)	0.87 (0.25, 1.48)	0.84 (0.23, 1.46)
Matsuda ISI	0.218	0.017	0.010	0.009	0.017	0.009	0.017	0.006	0.007
Stumvoll index	− 0.04 (− 0.67, 0.60)	− 0.38 (− 0.99, 0.23)	− 0.36 (− 0.97, 0.26)	− 0.38 (− 0.99, 0.23)	− 0.31 (− 0.93, 0.32)	− 0.36 (− 0.98, 0.26)	− 0.38 (− 1.00, 0.23)	− 0.39 (− 1.00, 0.23)	− 0.38 (− 1.00, 0.23)
Stumvoll index	0.910	0.222	0.255	0.224	0.337	0.256	0.219	0.218	0.223

Beta-coefficients above already adjusted for Model 1 covariates—age, sex, race, site, speckle-tracking analyst, echo image and quality score
BP blood pressure, LDL low-density lipoprotein, HDL high-density lipoprotein, eGFR_cys estimated glomerular filtration rate cystatin C, HOMA-IR homeostatic model of insulin resistance, ISI insulin sensitivity index

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