Background We investigated the associations of glycemic markers (HbA1C [hemoglobin A1C], fasting plasma glucose, and insulin resistance-homeostasis model assessment of insulin resistance) with subclinical cardiovascular disease (CVD) among blacks. Methods We included 4303 community-dwelling blacks (64% women; mean age, 54.5 years) without prevalent CVD. Subclinical CVD was defined as ≥1 of the following: any coronary artery calcification (CAC), elevated carotid intima-media thickness (cIMT), left ventricular (LV) hypertrophy, LV ejection fraction <50%, and peripheral artery disease (ankle-brachial index, <0.90). Estimates of cross-sectional associations of glycemic markers (fasting plasma glucose, HbA1C, and homeostasis model assessment of insulin resistance) with subclinical CVD measures were adjusted for traditional CVD risk factors. Results Each 1% increment in HbA1C was associated with higher odds of CAC, abnormal cIMT, and subclinical CVD (all P <0.001). Adjusted mean values of LV mass (LVM), LVM index, relative wall thickness, CAC, and cIMT were increasingly abnormal with worsening HbA1C categories (all P<0.05). Each 10-mg/dL increase in fasting plasma glucose was associated with higher odds of LV hypertrophy, CAC, abnormal cIMT, and subclinical CVD (all P <0.005). Adjusted mean values of LVM, LVM index, relative wall thickness, CAC, ankle-brachial index, and cIMT were more abnormal across categories of worsening fasting plasma glucose (all P <0.05). Each unit increment in log-transformed homeostasis model assessment of insulin resistance conferred a higher odd of having LV hypertrophy ( P<0.01). Across quartiles of homeostasis model assessment of insulin resistance, we observed progressively abnormal adjusted mean values of LVM, LVM index, relative wall thickness, and ankle-brachial index (all P <0.01). Conclusions Among blacks, glycemic markers were differentially associated with various measures of subclinical CVD.

中文翻译：

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血糖标记物和亚临床心血管疾病：杰克逊心脏研究。

背景 我们调查了血糖标记物（HbA1C [血红蛋白 A1C]、空腹血糖和胰岛素抵抗-胰岛素抵抗稳态模型评估）与黑人亚临床心血管疾病 (CVD) 的关联。方法 我们纳入了 4303 名未患心血管疾病的社区黑人（64% 为女性；平均年龄 54.5 岁）。亚临床 CVD 定义为以下≥1 项：任何冠状动脉钙化 (CAC)、颈动脉内膜中层厚度升高 (cIMT)、左心室 (LV) 肥大、左室射血分数 <50% 和外周动脉疾病（踝关节肱指数，<0.90)。针对传统的 CVD 危险因素调整了血糖标记物（空腹血糖、HbA1C 和胰岛素抵抗的稳态模型评估）与亚临床 CVD 测量的横断面关联的估计。结果 HbA1C 每增加 1% 与 CAC、异常 cIMT 和亚临床 CVD 的更高几率相关（所有 P <0.001）。随着 HbA1C 类别的恶化，LV 质量 (LVM)、LVM 指数、相对壁厚、CAC 和 cIMT 的调整平均值越来越不正常（所有 P <0.05）。空腹血糖每增加 10 mg/dL 与 LV 肥大、CAC、异常 cIMT 和亚临床 CVD 的几率增加相关（所有 P <0.005）。LVM、LVM 指数、相对壁厚、CAC、踝臂指数和 cIMT 的调整平均值在空腹血糖恶化的类别中更为异常（所有 P <0.05）。胰岛素抵抗的对数转换稳态模型评估中的每个单位增量赋予具有 LV 肥大的更高几率 (P<0.01)。在胰岛素抵抗稳态模型评估的四分位数中，我们观察到 LVM、LVM 指数、相对壁厚和踝臂指数的调整平均值逐渐异常（所有 P <0.01）。结论 在黑人中，血糖标记物与亚临床 CVD 的各种测量值有差异关联。