Association of impaired fasting glucose and coronary artery calcification as a marker of subclinical atherosclerosis in a population-based cohort—results of the Heinz Nixdorf Recall Study

Diabetologia (2009) 52:81–89 | DOI 10.1007/s00125-008-1173-y

– S. Moebus; A. Stang; S. Möhlenkamp; N. Dragano; A. Schmermund; U. Slomiany; B. Hoffmann; M. Bauer; M. Broecker-Preuss; K. Mann; J. Siegrist; R. Erbel; K.-H. Jöckel; for the Heinz Nixdorf Recall Study Group

Abstract
moebus-diabetologia-2008-tab1Aims/hypothesis Atherosclerosis and cardiovascular diseases are often present at the time of diagnosis of type 2 diabetes mellitus. Whether subclinical atherosclerosis can be detected in the pre-diabetic (borderline fasting hyperglycemia) state is not clear. This study investigated the association of impaired fasting glucose (IFG) and coronary artery calcification (CAC), a marker of subclinical atherosclerosis, among participants without a history of coronary heart disease or manifest diabetes mellitus.

moebus-diabetologia-2008-tab2Of 2,184 participants 29% (n=633) had IFG. Among men a higher prevalence than in women was observed (37% vs 22%). Characteristics of the study population according to the glucose status are shown in Table 1. Participants with IFG were particularly characterised by a higher mean BMI and waist circumference than those with NFG. Accordingly, more participants with IFG were classified as being obese (BMI ≥30 kg/m2). In addition the participants with IFG were more likely to be older and hypertensive. Dyslipidaemia,
smoking status and use of medications differed between sexes with regard to glucose status.
moebus-diabetologia-2008-fig1For both sexes a positive association between fasting plasma glucose levels and CAC can be shown (ESM Fig. 1). The prevalence of NFG and IFG by CAC risk group and age group is presented in Table 2. A higher proportion of men and women with NFG had no or only small amounts of CAC (<10) compared with those with IFG. On the other hand, participants with IFG were more likely to exhibit high amounts of CAC (≥400). However, in the age group 55–64 years as well as in the CAC risk-groups with values of CAC ≥10 to <100 and ≥10 to <400, this tendency is less pronounced, especially in men. (weiter …)