EVALUATION OF CARDIOVASCULAR AND METABOLIC RISK PROFILES IN PREDIABETES
Paul Kolm, PhD1, Lawrence S. Phillips, MD2, David C. Ziemer, MD2, Viola Vaccarino, MD, PhD2, Mary K. Rhee, MD2, Jovonne K. Foster, MS2, and William S. Weintraub, MD1. (1) Christiana Care Health System, Newark, DE, (2) Emory University, Atlanta, GA
Purpose: Patients with prediabetes, both impaired glucose tolerance (IGT – 2 hour oral glucose tolerance test 140-199 mg/dl) and impaired fasting glucose (IFG – fasting plasma glucose 100-125 mg/dl), are at increased risk for cardiovascular disease as well as diabetes. The purpose of this study was to assess differences in risk profiles of IFG and IGT subjects. Methods: From January, 2005 to May, 2006, 733 volunteer subjects were screened for diabetes by oral glucose tolerance tests. Eight metabolic and cardiovascular risk factors, including blood pressure, gender-corrected waist circumference, gender-corrected HDL, LDL, triglycerides, albumin/creatinine ratio, alanine aminotransferase (ALT) and C-reactive protein (CRP), were included for analysis. Risk factor profiles of IGT, IFG and IGT+IFG were compared to normal glucose tolerant (NGT) subjects using multinomial logistic regression. Results: Of the 733 subjects, 34 were diabetic and excluded from analysis; 60 (8%) were IGT; 116(16%) IFG; 58 (8%) were IGT and IFG; 465 (68%) were normal glucose tolerant (NGT). Logistic regression identified ALT as greatest risk factors for IFG and IGT+IFG. Waist circumference was the most significant risk factor for IGT. With respect to the entire risk profile, all 3 groups were significantly different from NGT subjects (p < 0.001). Conclusions: IGT and IFG may present with different risk factors for metabolic and cardiovascular disease. Evaluation of glucose-intolerant individuals for CVD should include both fasting and 2-hour glucose levels.