Impaired glucose tolerance. Why is it not a disease?

Perry, Rachel; Baron, Alain

doi:10.2337/diacare.22.6.883

Cited by 58 publications

(30 citation statements)

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“…In this sense, IGT is not recognized as a disease in itself but rather as a risk for future development of diabetes [38,39], despite that IGT can also be a marker of CVD risk [40,41]. Type II diabetes and IGT are associated with an increased CVD risk [1±6, 42±45].…”

Section: Discussionmentioning

confidence: 99%

Contribution of visceral obesity to the deterioration of the metabolic risk profile in men with impaired glucose tolerance

Pascot¹,

Després²,

Lemieux³

et al. 2000

Diabetologia

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Cardiovascular disease (CVD) mortality rates are increased in people with impaired glucose tolerance (IGT) [1±6]. This observation suggests that hyperglycaemia is associated with CVD, although it does not necessarily confirm that glucose intolerance in itself is causal in CVD [5]. Impaired glucose tolerance is a frequently observed condition and its prevalence varies widely depending upon the population studied. Its prevalence can be as high as 37 % in Finns and South Asian immigrants [6,7]. Determinants of IGT have been the topic of several investigations and include age, obesity (total and central), family history of Type II (non-insulin-dependent) diabetes mellitus, physical inactivity and high triglyceride concentrations [7]. Impaired glucose tolerance is known to be a powerful risk factor for Type II diabetes, with 20±50 % of people with IGT developing Type II diabetes ten years after IGT diagnosis [7]. Subjects with IGT have been shown to be abdominally obese [8±10]. An IGT state has also been associated with alterations in plasma lipid-lipoprotein concentrations [11±14]. Subjects with IGT are therefore Diabetologia (2000) Abstract Aims/hypothesis. Impaired glucose tolerance is associated with metabolic alterations which increase cardiovascular disease risk. The contribution of hyperglycaemia to this increased risk is, however, not clear. Abdominal obesity is often observed in subjects with impaired glucose tolerance; our objective was therefore to find the contribution of visceral adipose tissue to the deterioration of the metabolic risk profile noted in subjects with impaired glucose tolerance. Methods. We studied 284 men with a normal glucose tolerance and 66 men with impaired glucose tolerance which was defined as a glycaemia between 7.8 and 11.1 mmol/l 2 h after a 75-g glucose load.Results. Men with impaired glucose tolerance had more visceral adipose tissue and higher concentrations of plasma glucose and insulin in the fasting state and following a 75-g oral glucose load than men with a normal glucose tolerance. They also had higher concentrations of plasma cholesterol, triglycerides, apolipoprotein B and lower concentrations of HDLcholesterol as well as higher cholesterol:HDL-cholesterol ratios than men with a normal glucose tolerance. The two groups of men were then compared after a statistical adjustment for the amount of visceral adipose tissue. Although men with impaired glucose tolerance still had higher fasting plasma glucose and insulin concentrations after the adjustment for visceral adipose tissue, differences in all the variables of the lipid-lipoprotein profile were eliminated. Conclusion/interpretation. Visceral adipose tissue accumulation is an important factor in the deterioration of the plasma lipid-lipoprotein noted in men with impaired glucose tolerance. [Diabetologia 2000

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Section: Discussionmentioning

confidence: 99%

Contribution of visceral obesity to the deterioration of the metabolic risk profile in men with impaired glucose tolerance

Pascot¹,

Després²,

Lemieux³

et al. 2000

Diabetologia

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“…Assessment based on impaired fasting glucose has been criticized for including individuals with normal glucose tolerance and a significant minority with diabetes. 35 However, studies have shown that high proportions of individuals with impaired fasting glucose progress to diabetes. 7,8 Information on physical activity and dietary patterns were not available for our study, which may have confounded the results.…”

Section: Limitationsmentioning

confidence: 99%

Association between indices of obesity and fasting hyperglycemia in Taiwan

Chien¹,

Liou

Chen

2004

Int J Obes

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OBJECTIVE:To examine the association of body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) with fasting hyperglycemia after adjustment for age, cigarette smoking, and alcohol use. DESIGN: A cross-sectional survey was conducted among individuals visiting four health-screening centers across Taiwan. SUBJECTS: A total of 61 568 subjects (28 734 men and 32 834 women) between 25 and 64 years of age were included. Fasting hyperglycemia was defined as fasting plasma glucose Z6.1 mmol/l or current diagnosis and use of insulin or hypoglycemic agent. RESULTS: Fasting hyperglycemia was found in 11.0% of men and 8.3% of women. The factors significantly associated with fasting hyperglycemia in men were age, BMI, WHR, and heavy drinking, while for women these factors were age, educational level, BMI, WHR, and heavy smoking. For men, increased risk of fasting hyperglycemia started from age 30 to 34 years, BMI Z25 kg/m 2 , and WHR Z0.82. For women, increased risk of fasting hyperglycemia started from age 35 to 39 years, BMI Z24 kg/ m 2 , and WHR Z0.74. WC lost its significance as a predictor of fasting hyperglycemia when WHR included in the model. CONCLUSION: This study found that central obesity and general obesity were both independently associated with increased risk of fasting hyperglycemia in Taiwanese. The relationship between fasting hyperglycemia and central fat accumulation (WHR) begins to appear at levels that would not be regarded as representing obesity in Western populations, suggesting the need to redefine cutoffs for central obesity in this population.

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“…It was originally conceived to be an analogous condition to impaired glucose tolerance (IGT) (4). However, multiple reports have proved that there is a lack of agreement between IGT and IFG (5)(6)(7)(8). The prevalence of IGT was two times higher, and 40% of the IGT cases were considered normal using the fasting glycemia criterion.…”

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confidence: 99%

Lack of Agreement Between the Revised Criteria of Impaired Fasting Glucose and Impaired Glucose Tolerance in Children With Excess Body Weight

et al. 2004

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OBJECTIVE -The aim of this study was to describe the agreement between impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) in children with excess body weight using the original and the revised definitions of IFG.RESEARCH DESIGN AND METHODS -Obese and overweight children aged 4 -17 years were included (n ϭ 533). Anthropometric parameters and biochemical tests (fasting and 2-h glucose tests after an oral glucose load [1.75 g/kg]) were performed. Case subjects with a fasting plasma glucose Ն126 mg/dl were excluded. The diagnostic parameters of the original and the revised definitions of IFG for detecting IGT were estimated. The analysis of agreement between these categories was made using the test.RESULTS -The prevalence of IFG increased from 6.2 to 13.3% using the new criteria. The prevalence of IFG became closer to the prevalence of IGT (14.8%). The revised criteria increased the sensitivity from 26.6 to 36.7%. However, the new IFG definition was not useful for identifying IGT cases. Of the 71 case subjects with IFG, only 29 (40.8%) had IGT. In addition, 50 case subjects with IGT (9.4%) and 13 with diabetes (2.4%) had a fasting glycemia Ͻ100 mg/dl. CONCLUSIONS -The new definition modestly increases the sensitivity of IFG for detecting IGT in children with excess body weight. Despite this, more than one-half of these cases are not detected. In addition, the false-positive rate was increased by 61%. Diabetes Care 27:2229 -2233, 2004I mpaired fasting glucose (IFG) is associated with an increased risk for having type 2 diabetes and cardiovascular events (1-3). It was originally conceived to be an analogous condition to impaired glucose tolerance (IGT) (4). However, multiple reports have proved that there is a lack of agreement between IGT and IFG (5-8). The prevalence of IGT was two times higher, and 40% of the IGT cases were considered normal using the fasting glycemia criterion. Based on this, the Expert Committee on Diagnosis and Classification of Diabetes Mellitus of the American Diabetes Association recently changed the definition of IFG (9). The lower limit was changed from 110 to 100 mg/dl. This change is intended to get a similar prevalence of IGT and IFG.Childhood obesity is now a problem of epidemic proportions worldwide (10). In the U.S., 20% of children ages 6 -17 years are obese, and an additional 22% of them are overweight. The prevalence is greater in Mexican Americans and African Americans compared with Asian Americans or Caucasians. Childhood obesity is associated with an increased likelihood for having either IGT or IFG. In referral centers, the prevalence of IGT has been reported close to 25% in obese children 4 -10 years of age (11) and up to 4.1% in population-based surveys (12). Our purpose is to describe the agreement between IGT and IFG in children with excess body weight.RESEARCH DESIGN AND METHODS -Overweight or obese boys and girls, aged 4 -17 years (n ϭ 533), were included in the study. They were recruited from seven primary care units (n ϭ 168) and from one elementary sch...

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Impaired glucose tolerance. Why is it not a disease?

Cited by 58 publications

References 0 publications

Contribution of visceral obesity to the deterioration of the metabolic risk profile in men with impaired glucose tolerance

Contribution of visceral obesity to the deterioration of the metabolic risk profile in men with impaired glucose tolerance

Association between indices of obesity and fasting hyperglycemia in Taiwan

Lack of Agreement Between the Revised Criteria of Impaired Fasting Glucose and Impaired Glucose Tolerance in Children With Excess Body Weight

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