High-normal fasting blood glucose in non-diabetic range is associated with increased coronary artery calcium burden in asymptomatic men

Nasir, Khurram; Santos, Raul D.; Tufail, Kashif; Rivera, Juan J.; Carvalho, José A.M.; Meneghello, Romeu; Brady, Thomas D.; Blumenthal, Roger S.

doi:10.1016/j.atherosclerosis.2007.05.025

Cited by 30 publications

(15 citation statements)

References 38 publications

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“…Five of these studies adjusted for potential confounding risk factors, and, of these, three (6,8,9) showed a significant positive relationship between IFG and CAC, and the remaining two (3,5) showed nonsignificant results.…”

Section: Discussionmentioning

confidence: 99%

Fasting Glucose, Obesity, and Coronary Artery Calcification in Community-Based People Without Diabetes

et al. 2012

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OBJECTIVEOur objective was to assess whether impaired fasting glucose (IFG) and obesity are independently related to coronary artery calcification (CAC) in a community-based population.RESEARCH DESIGN AND METHODSWe assessed CAC using multidetector computed tomography in 3,054 Framingham Heart Study participants (mean [SD] age was 50 [10] years, 49% were women, 29% had IFG, and 25% were obese) free from known vascular disease or diabetes. We tested the hypothesis that IFG (5.6–6.9 mmol/L) and obesity (BMI ≥30 kg/m2) were independently associated with high CAC (>90th percentile for age and sex) after adjusting for hypertension, lipids, smoking, and medication.RESULTSHigh CAC was significantly related to IFG in an age- and sex-adjusted model (odds ratio 1.4 [95% CI 1.1–1.7], P = 0.002; referent: normal fasting glucose) and after further adjustment for obesity (1.3 [1.0–1.6], P = 0.045). However, IFG was not associated with high CAC in multivariable-adjusted models before (1.2 [0.9–1.4], P = 0.20) or after adjustment for obesity. Obesity was associated with high CAC in age- and sex-adjusted models (1.6 [1.3–2.0], P < 0.001) and in multivariable models that included IFG (1.4 [1.1–1.7], P = 0.005). Multivariable-adjusted spline regression models suggested nonlinear relationships linking high CAC with BMI (J-shaped), waist circumference (J-shaped), and fasting glucose.CONCLUSIONSIn this community-based cohort, CAC was associated with obesity, but not IFG, after adjusting for important confounders. With the increasing worldwide prevalence of obesity and nondiabetic hyperglycemia, these data underscore the importance of obesity in the pathogenesis of CAC.

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Section: Discussionmentioning

confidence: 99%

Fasting Glucose, Obesity, and Coronary Artery Calcification in Community-Based People Without Diabetes

et al. 2012

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“…Nevertheless, recent studies have also documented a higher risk of cardiac events with high FPG levels in non-diabetic range [20]. In fact, very recently FPG in the upper normal range was found to be associated with the presence of coronary artery calcium, a marker for atherosclerosis in non-diabetic men [22]. We recently showed that epicardial adipose tissue, index of cardiac adiposity is significantly related to carotid intimamedia thickness, index of subclinical atherosclerosis, in subjects with high visceral adiposity [14].…”

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confidence: 98%

Relationship of epicardial fat thickness and fasting glucose

Iacobellis¹,

Bárbaro²,

Gerstein³

2008

International Journal of Cardiology

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“…A higher normal FPG level has been illustrated to be associated with higher levels of arterial stiffness,13 the severity of coronary artery calcium,14 and the risk of cardiovascular disease 3. On the other hand, hypoglycemia or rapid changes in plasma glucose may lead to elevations of counterregulatory hormones, such as epinephrine and norepinephrine, and these increases induce vasoconstriction and platelet aggregation 3, 15.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of Long‐Term Normal Fasting Plasma Glucose and Risk of Coronary Heart Disease: A Prospective Cohort Study

Yuan

Yang

Wang

et al. 2018

JAHA

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BackgroundFasting plasma glucose (FPG) levels can vary over time and its longitudinal changing patterns may predict cardiometabolic risk. We aim to identify different trajectories of FPG in those who remained normoglycemic and investigate the association between trajectory groups and coronary heart disease risk in a large prospective cohort study.Methods and ResultsA total of 20 514 subjects between ages 20 and 80 years were included at baseline. All participants had maintained normal FPG throughout an average follow‐up period of 5.8 years. We identified 3 distinct trajectories using a group‐based trajectory model, labeled by initial value and changing pattern: low‐increasing (n=12 694), high‐increasing‐decreasing (n=5330), and high‐decreasing‐increasing (n=2490). The coronary heart disease incidence density among these 3 groups (3.00, 4.05, and 3.26 per 1000 person‐years, respectively) was significantly different (P=0.038). The high‐increasing‐decreasing group was characterized by a starting FPG of 4.80 mmol/L, and increased up to 5.42 mmol/L at age 55, then decreased thereafter. Treating the low‐increasing group as the reference, the age‐ and sex‐adjusted hazard ratio was 1.58 (95% confidence interval, 1.23–2.02) for the high‐increasing‐decreasing group by Cox proportional hazard regression. After adjustment for other potential confounding factors, the hazard ratio is 1.40 (95% confidence interval, 1.08–1.81). The association persisted after adjustment for baseline FPG, mean, or SD of FPG.ConclusionsDistinct trajectories of long‐term normal FPG are associated with the development of coronary heart disease, which is independent of other metabolic factors including FPG levels. These findings have implications for intervention and prevention of coronary heart disease among individuals who are normoglycemic.

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High-normal fasting blood glucose in non-diabetic range is associated with increased coronary artery calcium burden in asymptomatic men

Cited by 30 publications

References 38 publications

Fasting Glucose, Obesity, and Coronary Artery Calcification in Community-Based People Without Diabetes

Fasting Glucose, Obesity, and Coronary Artery Calcification in Community-Based People Without Diabetes

Relationship of epicardial fat thickness and fasting glucose

Trajectories of Long‐Term Normal Fasting Plasma Glucose and Risk of Coronary Heart Disease: A Prospective Cohort Study

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