Diabetes and pre-diabetes are associated with cardiovascular risk factors and carotid/femoral intima-media thickness independently of markers of insulin resistance and adiposity.

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Serval ID
serval:BIB_BD48CB7B6021
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Diabetes and pre-diabetes are associated with cardiovascular risk factors and carotid/femoral intima-media thickness independently of markers of insulin resistance and adiposity.
Journal
Cardiovascular Diabetology
Author(s)
Faeh D., William J., Yerly P., Paccaud F., Bovet P.
ISSN
1475-2840 (Electronic)
ISSN-L
1475-2840
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
6
Pages
32
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
BACKGROUND: Impaired glucose regulation (IGR) is associated with detrimental cardiovascular outcomes such as cardiovascular disease risk factors (CVD risk factors) or intima-media thickness (IMT). Our aim was to examine whether these associations are mediated by body mass index (BMI), waist circumference (waist) or fasting serum insulin (insulin) in a population in the African region.
METHODS: Major CVD risk factors (systolic blood pressure, smoking, LDL-cholesterol, HDL-cholesterol,) were measured in a random sample of adults aged 25-64 in the Seychelles (n = 1255, participation rate: 80.2%). According to the criteria of the American Diabetes Association, IGR was divided in four ordered categories: 1) normal fasting glucose (NFG), 2) impaired fasting glucose (IFG) and normal glucose tolerance (IFG/NGT), 3) IFG and impaired glucose tolerance (IFG/IGT), and 4) diabetes mellitus (DM). Carotid and femoral IMT was assessed by ultrasound (n = 496).
RESULTS: Age-adjusted levels of the major CVD risk factors worsened gradually across IGR categories (NFG < IFG/NGT < IFG/IGT < DM), particularly HDL-cholesterol and blood pressure (p for trend < 0.001). These relationships were marginally attenuated upon further adjustment for waist, BMI or insulin (whether considered alone or combined) and most of these relationships remained significant. With regards to IMT, the association was null with IFG/NGT, weak with IFG/IGT and stronger with DM (all more markedly at femoral than carotid levels). The associations between IMT and IFG/IGT or DM (adjusted by age and major CVD risk factors) decreased only marginally upon further adjustment for BMI, waist or insulin. Further adjustment for family history of diabetes did not alter the results.
CONCLUSION: We found graded relationships between IGR categories and both major CVD risk factors and carotid/femoral IMT. These relationships were only partly accounted for by BMI, waist and insulin. This suggests that increased CVD-risk associated with IGR is also mediated by factors other than the considered markers of adiposity and insulin resistance. The results also imply that IGR and associated major CVD risk factors should be systematically screened and appropriately managed.
Keywords
Adiposity, Adult, Blood Glucose/metabolism, Blood Pressure, Cardiovascular Diseases/etiology, Cardiovascular Diseases/physiopathology, Carotid Arteries/ultrasonography, Cholesterol, HDL/blood, Diabetes Complications, Diabetes Mellitus/diagnosis, Female, Femoral Artery/ultrasonography, Humans, Insulin Resistance, Male, Middle Aged, Prediabetic State/complications, Prediabetic State/diagnosis, Risk Factors, Tunica Intima/ultrasonography, Tunica Media/ultrasonography
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2008 14:57
Last modification date
20/08/2019 15:31
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