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|Title: ||Mandatory oral glucose tolerance tests identify more diabetics in stable patients with chronic heart failure: a prospective observational study.|
|Authors: ||Stevens, An|
Eijnde, Bert O.
|Issue Date: ||2014|
|Citation: ||Diabetology & Metabolic Syndrome, 6(1), (ART N° 44)|
|Abstract: ||BACKGROUND: Many patients with chronic heart failure (CHF) are believed to have unrecognized diabetes, which is associated with a worse prognosis. This study aimed to describe glucose tolerance in a general stable CHF population and to identify determinants of glucose tolerance focusing on body composition and skeletal muscle strength.
METHODS: A prospective observational study was set up. Inclusion criteria were diagnosis of CHF, stable condition and absence of glucose-lowering medication. Patients underwent a 2 h oral glucose tolerance test (OGTT), isometric strength testing of the upper leg and dual energy x-ray absorptiometry. Health-related quality of life and physical activity level were assessed by questionnaire.
RESULTS: Data of 56 participants were analyzed. Despite near-normal fasting glucose values, 55% was classified as prediabetic, 14% as diabetic, and 20% as normal glucose tolerant. Of all newly diagnosed diabetic patients, 79% were diagnosed because of 2 h glucose values only and none because of HbA1c. Univariate mixed model analysis revealed ischaemic aetiology, daily physical activity, E/E', fat trunk/fat limbs and extension strength as possible explanatory variables for the glucose curve during the glucose tolerance test. When combined in one model, only fat trunk/fat limbs and E/E' remained significant predictors. Furthermore, fasting insulin was correlated with fat mass/height2 (r = 0.51, p < 0.0001), extension strength (r = -0.33, p < 0.01) and triglycerides (r = 0.39, p < 0.01).
CONCLUSIONS: Our data confirm that a large majority of CHF patients have impaired glucose tolerance. This glucose intolerance is related to fat distribution and left ventricular end-diastolic pressure.|
|Notes: ||Stevens, ALM (reprint author), Hasselt Univ, REVAL Rehabil Res Ctr, Martelarenlaan 42, BE-3500 Hasselt, Belgium, firstname.lastname@example.org|
|ISI #: ||000334617500001|
|Type: ||Journal Contribution|
|Validation: ||ecoom, 2015|
|Appears in Collections: ||Research publications|
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