A comparison of left ventricular abnormalities associated with glucose intolerance in African Caribbeans and Europeans in the UK
- aDepartment of Epidemiology and Public Health, University College London, 1-9 Torrington Place, London WC1E 6BT, UK, bEpidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7EH, UK, cCardiology Department, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
- Professor N Chaturvedi, Department of Epidemiology and Public Health, Imperial College at St Mary's, Norfolk Place, London W2 1PG, UK n.chaturvedi@.ic.ac.uk
- Accepted 20 February 2001
Abstract
OBJECTIVE To determine whether abnormalities of the left ventricle differ by glucose tolerance status, to explore reasons for differences, and to assess ethnic differences in these relations.
DESIGN Population based prevalence study.
SETTING London, UK.
PATIENTS 1152 African Caribbeans and Europeans.
METHODS Echocardiograms, blood pressure, obesity, fasting and two hour blood glucose, insulin and lipids, and urinary albumin excretion rate were measured.
MAIN OUTCOME MEASURES Left ventricular mass index, wall thickness, and early (E) to atrial (A) wave ratio.
RESULTS Left ventricular mass index was greater in diabetic Europeans than in normoglycaemic Europeans (mean (SE), 95.6 (5.0) v 79.7 (0.8) g/m2, p = 0.001) and in diabetic African Caribbeans than in normoglycaemic African Caribbeans (88.6 (2.5)v 82.4 (0.9) g/m2, p = 0.02). Similar, but weaker associations were observed for the E:A ratio. β Coefficients between left ventricular mass index and fasting glucose in the normoglycaemic range, adjusted for age and sex, were 2.43 in Europeans (p = 0.05) and 3.74 in African Caribbeans (p = 0.02). These were attenuated to 1.19 (p = 0.4) and 3.03 (p = 0.08) in Europeans and African Caribbeans, respectively, when adjusted further for blood pressure and obesity. Adjustments for other risk factors made little difference to the coefficients. There were no ethnic differences in risk factor relations.
CONCLUSIONS Abnormalities of the left ventricle occur in response to glucose intolerance and are observable into the normoglycaemic range. These disturbances are largely accounted for by associated obesity and hypertension. African Caribbeans have a greater degree of left ventricular structural impairment, emphasising the importance of tight blood pressure control.
