Association between markers of glycemia and carotid intima-media thickness: the MARK study

Abstract

BackgroundCarotid intima-media thickness (C-IMT) is a reliable predictor of cardiovascular events. We Investigated the relationship between markers of glycemia and C-IMT in intermediate-risk cardiovascular patients.MethodsThis study analyzed 427 subjects, aged 35 to 74 years (mean, 60.3 ± 8.5 years), 55 % women, enrolled into the MARK study. Including 231 subjects defined as normal glucose, 104 subjects classified as prediabetes and 92 with type 2 diabetes mellitus. Carotid ultrasound was used to measure C-IMT and the presence of plaques. Fasting plasma glucose (mg/dl) and glycated hemoglobin (%) (HbA1c) were measured using standard enzymatic automated methods. Postprandial glucose (mg/dl) was self-measured by patients at home 2 h after meals (breakfast, lunch and dinner) for 1 day.ResultsThe C-IMT shows a positive correlation with fasting plasma glucose, postprandial glucose and HbA1c. Multiple linear regression analysis showed a positive association between HbA1c and C-IMT, with a 0.016 mm and 0.019 mm increase in mean and maximum C-IMT per 1 % increase in HbA1c. In addition, an association between fasting plasma glucose and C-IMT was found with an increase of 0.004 and 0.005 mm in mean and maximum C-IMT per 10 mg/dl in fasting plasma glucose. We also observed a graded association between fasting plasma glucose, postprandial glucose and HbA1c and the presence of carotid target organ damage (TOD), with an odds ratio of 1.013, 1.010 and 1.425, respectively.ConclusionThe results of this study suggest that the fasting plasma glucose and HbA1c, but not postprandial glucose, are associated with C-IMT media and maximum. The patients who present with a metabolic glucose alteration have more risk of developing carotid TOD.Trial registrationClinicalTrials.gov; Identifier: NCT01428934.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0380-6) contains supplementary material, which is available to authorized users.

Anthropometric, metabolic and clinical factors associated with diabetes and prediabetes prevalence in women aged 65–74 living in central Poland

“…In our study ABI was not associated with any abnormal pattern of glucose metabolism. In the study by Gomez--Marcos et al CIMT was related to HbA 1c and fasting, but not postprandial, plasma glucose [22]. We also revealed relationship between fasting glycemia and CIMT, while we did not measure HbA 1c in our study.…”

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“…12,13 In a study, there was a positive correlation between fasting blood glucose and cIMT in the absence of DM. 14 Van der Zilj et al 15 found that patients with pre-DM have a higher content of pancreatic fat; another study showed that cIMT values were higher in patients with pre-DM than those with normal glucose metabolism. 16 Ye et al showed that NAFPD was significantly associated with an increased risk of metabolic syndrome and its components except HL.…”

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“…Nevertheless, a recent longitudinal study clearly demonstrated that MetS is independently associated with an increased 20-year all-cause mortality [ 42 ]. In addition, MetS and all its components are associated with unfavourable cardiovascular changes such as increased arterial stiffness, coronary calcium, diastolic dysfunction and carotid intima media thickness [ 43 – 45 ].…”