Assessment of QRISK3 Score in Normoglycaemic, Prediabetic and Diabetic Subjects: An Observational Study

Abstract

Introduction: Cardiovascular Disease (CVD) and diabetes mellitus have a high correlation. Compared to individuals without diabetes, adults with diabetes have a greater prevalence rate of CVDs. This risk steadily increases along with Fasting Blood Glucose (FBG) levels, even before they are high enough to be classified as diabetes. One of the factors contributing to death among people with diabetes mellitus is CVD. QRISK3 algorithm calculates a person's risk of developing a heart attack or stroke over the next 10 years. Aim: To assess the QRISK3 cardiovascular risk score in normoglycaemic, prediabetic and diabetic subjects. Materials and Methods: The present analytical observational study was carried out in the Department of Physiology and Medicine, RUHS College of Medical Sciences and associated Hospital, Jaipur, India, from November 2021 to April 2022. A total of 200 subjects were recruited with >20% QRISK3 CVD risk scores out of 7154 screened patients. Subjects were categorised into three groups (normoglycaemic, prediabetics and diabetics) according to American Diabetes Association criteria. The following parameters were recorded for data collection: anthropometric {Body Mass Index (BMI) Waist Hip Ratio (WHR)}, blood pressure and biochemical {Fasting Blood Glucose (FBG), Glycated Haemoglobin (HbA1c) and lipid profile parameters). All data collected was entered into Microsoft Excel sheet 2019 and was analysed with help of Statistical Package for the Social Sciences (SPSS) software version 21.0 and tests of significance considering level of significance as p-value<0.05. Data was analysed by applying Analysis of Variance (ANOVA). Results: According to the American Diabetes Association (ADA) for Diabetes Classification, there were 44 (26.19%) normoglycaemic, 21 (12.5%) prediabetic and 103 (61.31%) diabetic subjects out of the total 200 high-risk subjects. the mean age of was 49.06±9.65 years, 51.15±11.05 years and 51.02±9.74 years for normoglycaemic, prediabetic and diabetic subjects, respectively. There was significant difference of mean values of FBG, HbA1c, total cholesterol, High Density Lipoprotein (HDL), Cholesterol (Chl)/HDL ratio, Low Density Lipoprotein (LDL), Triglycerides (TG) and QRISK3 score in three groups. But there was no significant difference in following parameters i.e., age, weight, height, Body Mass Index (BMI), waist-hip circumference, WHR, Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP). There was hypertriglyceridaemia and low HDL level in prediabetic and diabetic subjects. Conclusion: The present study showed that the cluster of risk factors for CVD also grows as FBG levels and HbA1c levels increase. This study could also assert that these risk factors also increasing with progression of diabetes, which eventually results in increase in risk of CVDs.