Association between fasting plasma glucose and left ventricular mass and left ventricular hypertrophy over 4 years in a healthy population aged 60 and older

OBJETIVES: To test the association between fasting glucose level and left ventricular mass (LVM) and left ventricular hypertrophy (LVH) in people aged 60 and older. DESIGN: Population-based prospective study with 4-year follow-up. SETTING: Department of Internal Medicine and Family Medicine, Kaohsiung Medical University (KMU), Chung-Ho Memorial Hospital, and Graduate Institute of Medicine and Public Health, KMU. PARTICIPANTS: Of 1,500 people screened, 105 without symptoms or signs of diabetes mellitus, hypertension, or cardiovascular disease were recruited from senior activity centers in Kaohsiung city. MEASUREMENTS: All received two-dimensional echocardiography and fasting glucose examination at baseline and at 2- and 4-year follow-up. LVH was defined as a LVM index (LVMI) greater than 122.4 g/m(2) or 51 g/m(2.7). RESULTS: Age ranged from 60 to 81 (mean 71.7 +/- 3.9). Baseline glucose ranged from 83 to 118 mg/dL (mean 99.7 +/- 7.9 mg/dL). LVMI was significantly higher at the 4-year follow-up (97.5 +/- 24.9 vs 104.5 +/- 27.5 g/m(2) and 44.2 +/- 12.1 vs 47.2 +/- 13.4 g/m(2.7), both P <.01), as was the occurrence of LVH (16% vs 32% and 25% vs 39%, both P <.01). Baseline glucose correlates with 4-year change in LVMI (both P <.02). In the fourth year, baseline glucose was a significant predictor of LVMI (both P <.01) and LVH (P=.03 in g/m(2) definition) using logistic regression analysis. CONCLUSION: Because fasting glucose is an independent predictor for greater LVM and for development of LVH, it should be considered in assessment of cardiac disease and LVM in healthy older people without diabetes mellitus.