Unrecognized glucose intolerance is common in pulmonary arterial hypertension.
Unrecognized glucose intolerance is common in pulmonary arterial hypertension.
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DOI：
10.1016/j.healun.2011.02.016
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发表时间：
2011-08
期刊：
影响因子：
--
通讯作者：
Hemnes AR
中科院分区：
文献类型：
--
作者：
Pugh ME;Robbins IM;Rice TW;West J;Newman JH;Hemnes AR
Animal and human data suggest insulin resistance is common in pulmonary arterial hypertension (PAH). Although routine assessment of insulin resistance is difficult, hemoglobin A1c (HbA1c) is a sensitive test to detect diabetes mellitus (DM) and those at high risk for diabetes. We aimed to define the prevalence of elevated HbA1c in PAH patients and to correlate HbA1c with functional assessment. HbA1c was measured in 41 PAH patients without a diagnosis of DM, along with demographic, functional, and hemodynamic data. Using published criteria, HbA1c ≤ 5.9% defined normal, 6.0–6.4% glucose intolerance, and ≥ 6.5% diabetes. Twenty-three patients (56%) had HbA1c ≥ 6.0%, 6 patients (15%) had unrecognized DM (HbA1c ≥ 6.5%). Age and body mass index were similar in patients with HbA1c ≥ 6.0% versus HbA1c < 6.0%. There was a trend towards lower mean six-minute walk distance in patients with elevated HbA1c (331.0 ± 126.6 meters versus 413.6 ± 74.9 meters, p=0.07). Six-month event-free survival was not significantly different in patients with elevated HbA1c. Unrecognized glucose intolerance as assessed by HbA1c is common in PAH. Further studies are needed to discern if glucose or insulin dysregulation mediates PAH pathogenesis or is secondary to advanced PAH.
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