Myocardial Work Stress is Linked to the Levels of Glycated Hemoglobin in Indian Prediabetic Population

Abstract

Background and Aim: Cardiovascular disease and diabetes mellitus are major health concerns In India. Prediabetes shares common pathology with these two diseases. However, the factors contributing to myocardial dysfunction in prediabetes have not been assessed. In this study, we have assessed various cardiometabolic factors contributing to myocardial work stress in in prediabetic subjects. Methods: In the present study, the anthropometric parameters, parameters of insulin resistance, inflammation, oxidative stress, glycated hemoglobin (HbA1c), lipid profile, atherogenic lipid risk factors and Rate-pressure Product (RPP), the marker of myocardial work stress were assessed in early middle-aged prediabetes population (n=33) and compared with healthy non-diabetic controls (n=36). Results: Prediabetes subjects had increased body mass index (P<0.01), waist-hip ratio (P<0.05), lipid risk factors of atherosclerosis [TC/ HDL-C; P<0.05, LDL C/ HDL-C; P<0.05 and atherogenic index (AI) P<0.05], HbA1c (P<0.001), oxidative stress (increased malondialdehyde; P<0.001 and decreased total antioxidant status, P<0.001) and increased high-sensitive C-reactive protein (P<0.01). They had higher Basal Heart Rate (BHR) (P<0.05) and RPP (P<0.05) denoting increased CV risk in comparison to controls. Conclusion: There is myocardial work stress in the form of increased RPP in Indian prediabetic population. The RPP in prediabetes could be linked to increases HbA1c. RPP being a non-invasive risk marker may be studied further to assess its implication as a screening tool for determining CV risks in prediabetes.