HbA1c Identifies Subjects With Prediabetes and Subclinical Left Ventricular Diastolic Dysfunction

Area of Science:

• Cardiology
• Endocrinology
• Metabolic Diseases

Background:

• Prediabetes is linked to subclinical cardiac changes, potentially leading to heart failure.
• Early detection of cardiac alterations in prediabetes is crucial for cardiovascular disease prevention.

Purpose of the Study:

• To investigate diastolic function in prediabetes defined by HbA1c.
• To explore the association between cardiac changes, glycation (HbA1c, sRAGEs, esRAGE), and inflammation in prediabetes.

Main Methods:

• Cross-sectional study of 167 subjects with normal fasting glucose/normal glucose tolerance.
• Stratification into control (<5.7% HbA1c) and prediabetes (5.7%-6.4% HbA1c) groups.
• Evaluation of Doppler echocardiography, HbA1c, OGTT, sRAGEs, and esRAGE.

Main Results:

• HbA1c prediabetes group showed impaired diastolic function (lower E/A ratio) and increased left atrial volume and sphericity.
• HbA1c, sRAGEs, and esRAGE were identified as key determinants of these cardiac alterations.
• These cardiac changes were present despite normal fasting glucose and oral glucose tolerance test results.

Conclusions:

• Prediabetes, particularly when identified by HbA1c, is associated with subclinical cardiac alterations.
• Glycation markers (HbA1c, sRAGEs, esRAGE) play a significant role in these cardiac changes.
• Relying solely on fasting glucose or OGTT may miss individuals with prediabetes and associated cardiac risks.