Changes in Impaired Fasting Glucose and Borderline High Low-Density Lipoprotein-Cholesterol Status Alter the Risk of Cardiovascular Disease: A 9-Year Prospective Cohort Study

Abstract

BackgroundWe aimed to characterize the relationships of the changes in impaired fasting glucose (IFG) and borderline high low-density lipoprotein-cholesterol (LDL-C) status with cardiovascular disease (CVD).MethodsA total of 36,537 participants who did not have previous CVD, diabetes mellitus, or high LDL-C (≥ 4.1 mmol/L), nor were taking lipid-lowering drugs were recruited from the Kailuan study. The participants were allocated to six groups according to their baseline and follow-up fasting blood glucose (FBG) and LDL-C concentrations: (1) both were normal; (2) both normal at baseline, one abnormality subsequently; (3) both normal at baseline, both abnormal subsequently; (4) at least one abnormality that became normal; (5) at least one abnormality at baseline, a single abnormality subsequently; and (6) at least one abnormality, two abnormalities subsequently. The outcomes were CVD and subtypes of CVD (myocardial infarction and stroke). Multiple Cox regression models were used to calculate adjusted hazard ratio (HR) and confidence interval (95% CI).ResultsDuring a median follow-up period of 9.00 years, 1,753 participants experienced a CVD event. After adjustment for covariates, participants with IFG in combination with a borderline high LDL-C status at baseline and follow-up had higher risks of CVD (HR: 1.52; 95% CI: 1.04–2.23 and HR: 1.38, 95% CI: 1.13–1.70, respectively) compared with those with normal fasting blood glucose and LDL-C. Compared with participants that remained normal, those who changed from normality to having two abnormalities were at a higher risk of CVD (HR: 1.26; 95% CI: 0.98–1.61), as were those who changed from at least one abnormality to two abnormalities (HR: 1.48, 95% CI: 1.02–2.15).ConclusionChanges in IFG and borderline high LDL-C status alter the risk of CVD and its subtype, implying that it is important to focus on such individuals for the prevention and control of CVD.

Construction and Validation of a Model for Predicting Impaired Fasting Glucose Based on More Than 4000 General Population

“…Tips from previous research suggest that abnormal glucose metabolism in patients with IFG can be alleviated through health education, dietary intervention, physical exercise, drug treatment, and other measures, 2–5 and without timely intervention, the abnormal state of glucose metabolism in IFG may continue to deteriorate and lead to irreversible damage. IFG has been shown to be closely associated with an increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), 6 , 7 and IFG is also associated with atrial fibrillation, heart failure, ventricular septal hypertrophy, cerebral hemorrhage, all-cause mortality, and cardiovascular event outcomes. 8–11 No doubt, IFG has become a public health problem that cannot be ignored, because IFG-related diseases bring a huge burden to medical care and the economy, and the worst is the burden of T2DM and CVD.…”