Abstract 9389: Pre- Diabetes and the Risk of Incident Diabetes Mellitus and Cardiovascular Events in an Adult Population. MESA
Background: Hyperglycemia is a well-established cardiovascular risk factor; however, the association between impaired fasting glucose (IFG) (100 – 125mg/dl) and cardiovascular disease (CVD) is less clear. We assessed the association of IFG with incident diabetes mellitus(Dm) and CVD events in the Multi Ethnic Study of Atherosclerosis (MESA).
Methods and Design: Fasting blood glucose was measured in 6790 subjects with mean age 62.2 years, 53% females, 38% Caucasian, 12% Chinese, 28% African American and 22% Hispanics participating in the MESA study, a population based cohort study of adults free of clinical CVD at baseline recruited at six clinic sites in USA. Cox proportional hazard analysis was used to assess the association between IFG and incident Dm and also with seven years of adjudicated incident CVD events including MI, resuscitated cardiac arrest, definite and probable angina, stroke, stroke death, CVD death and other atherosclerotic death. Multivariable Cox analysis was adjusted for age, gender, BMI, race/ethnicity, SBP, total cholesterol, HDL, cigarette smoking, BP medication use and statin use.
Results: Out of the 6790 participants, 859 had Dm, 939 had IFG and 4992 had normoglycemia (NG).There were 383 adjudicated CV events (Dm= 100 and IFG + NG = 283). Dm was associated with CVD events in the univariate [hazard ratio (HR); 1.71(1.52 – 1.92), p<0.0001] and multivariable models [HR; 1.35(1.19 – 1.54) compared with non diabetics. IFG was associated with incident Dm in the univariate [HR; 6.08(4.40 – 8.40), p<0.0001] and after adjusting for age, gender and BMI [HR; 4.27(3.00 – 5.91), p<0.0001] compared with NG. IFG was associated with CVD events in the univariate [HR; 1.55(1.18 – 2.03), p=0.002],after adjusting for age, gender and race/ethnicity [HR; 1.37(1.03 – 1.81), p=0.02] but not in the full multivariable model[HR; 1.06(0.80 – 1.41), p=0.68] nor in the race or gender stratified analysis compared with NG. IFG' who developed Dm during the follow-up period had a high CVD events compared with those who did not develop Dm in both the univariate [HR; 5.51(3.26 – 9.33), p<0.0001] and multivariable models [HR; 4.64(2.66 – 8.09), p<0.0001].
Conclusions: Despite the increased risk for Dm, IFG per se is not an independent CVD risk factor in population based adults.
- © 2010 by American Heart Association, Inc.