Dysglycaemia in non-diabetic hypertensive patients: comparison of the impact of two different classifications of impaired fasting glucose on the cardiovascular risk profile

Abstract

The clinical correlates and risk profile of prediabetes (fasting plasma glucose (FPG) values in the upper normal limits but below the diabetic threshold) in hypertension, an insulin-resistant, prodiabetogenic condition, are scarcely known. For this reason, we evaluated 982 non-diabetic (FPG,<126 mg 100 ml(-1) and no antidiabetic treatment) referred hypertensive patients without a history of cardiovascular disease grouped by mild (100-109 mg 100 ml(-1)) and advanced (110-125 mg 100 ml(-1)) dysglycaemia compared with normal FPG (<100 mg 100 ml(-1)). FPG, total and high density lipoprotein (HDL) cholesterol, triglycerides and total white blood cell count were assessed by standard methodologies; 10-year predicted coronary heart disease (CHD) risk was approximated by the Framingham risk score (FRS). Metabolic syndrome (MetS) was diagnosed by standard categorical criteria using either 110 or 100 mg 100 ml(-1) as a threshold for impaired fasting glucose (IFG). FPG was above 110 in 13% and between 100 and 109 in 20% of patients. In both dysglycaemic groups, perturbed glucose homeostasis was associated with abnormally high fasting triglycerides, low HDL cholesterol, obesity, worse CHD risk profile and higher white blood cell count. MetS was highly prevalent and its distribution pattern was markedly influenced by the definitions of IFG based on different FPG cutoffs. Thus, even mildly perturbed glucose homeostasis associates with atherogenic dyslipidaemia, obesity and adverse risk profile in non-diabetic hypertensive patients. Because of its prediabetic nature, dysglycaemia should prompt measures to prevent new-onset diabetes, although the role of IFG as an independent risk factor awaits specifically designed intervention trials

Glucose homeostasis abnormalities among Cameroon patients with newly diagnosed hypertension

“…In the present survey, 23.7% of patients had IFG and 6.8% had PD, yielding an overall frequency of abnormal glucose homeostasis of 38.3%. These findings are similar to those observed in developed countries, with regard to the aforementioned study on 982 nondiabetic Caucasian patients with hypertension in whom 33% had IFG . A US study of 1547 adult nondiabetic participants using the 2003 ADA criteria recorded a 34.6% prevalence of prediabetes and a 19.4% prevalence of IFG .…”

Small High‐Density Lipoprotein (HDL) Subclasses are Increased with Decreased Activity of HDL‐Associated Phospholipase A2 in Subjects with Prediabetes

“…We noticed increased TAG levels combined with a trend of a decrease in HDL-C levels in prediabetic subjects. Previous studies have shown dyslipidemia characterized by increased TAG levels and decreased HDL-C concentration in subjects with prediabetes [48]. We report for the first time that apoC-II and apoC-III concentration did not differ between prediabetic and non-prediabetic subjects.…”

Lack of a relationship between circulating gamma-glutamyltransferase levels and carotid intima media thickness in hypertensive and diabetic patients

“…Metabolic syndrome (MetS) was defined according to National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria10 in the presence of at least three of the following criteria: antihypertensive treatment or BP >130/85 mmHg, triglycerides ≥150 mg/dL, HDL-C <40 mg/dL in males and <50 mg/dL in females, glucose-lowering treatment, or FPG >110 mg/dL, abdominal obesity. The thresholds for abdominal obesity were BMI ≥29.5 kg/m 2 and ≥27.2 kg/m 2 in men and women, respectively since those values corresponded to 102 cm and 88 cm of waist circumference in men and women, respectively, in a regression of BMI on the waist as validated previously 11. Smokers were either categorized as current smokers independent of the number of cigarettes they had per day or as never/previous smokers, meaning tobacco-free for at least 6 months.…”