Hyperglycemia Has a Greater Impact on Left Ventricle Function in South Asians Than in Europeans

OBJECTIVE Diabetes is associated with left ventricular (LV) diastolic and systolic dysfunction. SouthAsiansmaybeatparticularriskofdevelopingLVdysfunctionowingtoahigh prevalenceofdiabetes.Weinvestigatedtheroleofdiabetesandhyperglycemiain LV dysfunction in a community-based cohort of older South Asians and white Europeans. RESEARCH DESIGN AND METHODS Conventional and Doppler echocardiography was performed in 999 participants (542 Europeans and 457 South Asians aged 58–86 years) in a population-based study. Anthropometry, fasting bloods, coronary artery calcification scoring, blood pressure, and renal function were measured. RESULTS Diabetes and hyperglycemia across the spectrum of HbA1c had a greater adverse effect on LV function in South Asians than Europeans (N-terminal-probrain natriuretic peptide b6 SE 0.09 6 0.04, P = 0.01, vs. 20.04 6 0.05, P =0 .4,P for HbA1c/ethnicity interaction 0.02), diastolic function (E/e9 0.69 60.12, P < 0.0001, vs. 0.09 6 0.2, P =0 .6,P for interaction 0.005), and systolic function (s 92 0.11 6 0.06, P = 0.04, vs. 0.14 6 0.09, P = 0.1, P for interaction 0.2). Multivariable adjustment for hypertension, microvascular disease, LV mass, coronary disease, and dyslipidemia only partially accounted for the ethnic differences. Adverse LV function in diabetic South Asians could not be accounted for by poorer glycemic control or longer diabetes duration.