Abstract 11116: Prevalence of Impaired Fasting Glucose in Healthy Middle-Aged Adults: Insights from the Primary Care Audit of Global Risk Management (PARADIGM) Study

Abstract

BACKGROUND: Impaired fasting glucose (IFG) is associated with an increased risk of type 2 diabetes, cardiovascular disease, and all-cause mortality. We assessed the prevalence of IFG and associated clinical characteristics in healthy, middle-aged Canadians in the PARADIGM study.

METHODS: PARADIGM enrolled 3015 otherwise healthy men (>40y) and women (>50y), free of vascular disease or diabetes, in an observational primary prevention registry. The present analysis reports on those subjects who were found to have IFG, defined as fasting blood glucose level 100-125 mg/dL, within this cohort.

RESULTS: The overall prevalence of IFG in the PARADIGM population was 34% (n=1003). Subjects with IFG were slightly older than the subjects without IFG (56.8±8.5 y vs 56±8.3 y, p<.05). Subjects with IFG had a higher body mass index (BMI) (28.7±5.5 vs 27.2±4.8 kg/m², p<0.00001), greater waist circumference (38.6±5.5 inches vs 36.5±5.1 inches, p<0.00001) and were more likely to have the metabolic syndrome (49.7 vs 17%, p<0.00001), to have hypertension (35.4 vs 27.3%, p<0.00001), and to be of male gender (38.6 vs 27.5%, p<0.00001). IFG was more prevalent in South Asians when compared to Chinese Canadians (40.3 vs 30.2%, p<.05). HDL and triglycerides were also discriminators of IFG prevalence (p <0.00001). However, total cholesterol and LDL levels did not differ significantly between IFG and non-IFG subjects in multivariate analysis. Levels of hsCRP were significantly higher in IFG subjects (3.4±4.5 vs 2.7±4.1mg/L, p<0.00001). Subjects with IFG exhibited higher rates of urinary microalbuminuria compared to individuals without IFG, despite similar renal function as assessed by eGFR (77±15.7 vs 77.7±16.1, ml/min/1.73m², p=NS). The mean total cardiovascular Framingham Risk Score (FRS) was higher for subjects with IFG compared to those without IFG (17.1 vs 13.3%, p<.00001). Furthermore, 68% of IFG subjects were at moderate to high risk by FRS, compared to 50% of non-IFG subjects.

CONCLUSIONS: Our analysis identifies that IFG is common in otherwise healthy, non-diabetic Canadians without vascular disease. Importantly, despite similar total cholesterol and LDL-cholesterol levels, IFG patients were at significantly higher global cardiovascular risk.