Prediabetes Is Independently Associated with Subclinical Carotid Atherosclerosis: An Observational Study in a Non-Urban Mediterranean Population

Abstract

<jats:p>This was a prospective, observational study to compare the burden of subclinical atherosclerosis as measured by carotid ultrasonography in a cohort of subjects with prediabetes vs. subjects with normal glucose tolerance (NGT) from a non-urban Mediterranean population. Atherosclerosis was assessed through carotid intima-media thickness (c-IMT), the presence/absence of carotid plaques, and plaque number. Among 550 subjects included, 224 (40.7%) had prediabetes. The mean c-IMT and the prevalence of carotid plaque were significantly higher in the prediabetes group compared to the NGT group (0.72 vs. 0.67 mm, p &lt; 0.001; and 37.9% vs. 19.6%; p &lt; 0.001, respectively). Older age, male gender, and increased systolic blood pressure were positively correlated with c-IMT and were independent predictors of the presence of plaques. In contrast, prediabetes and low-density lipoprotein (LDL)-c were predictors of the presence of plaque (odds ratio [OR] = 1.64; 95% confidence interval [CI] = 1.05–2.57; p = 0.03 and OR = 1.01; 95% CI = 1.00–1.02; p = 0.006, respectively) together with tobacco exposure and the leukocyte count (OR = 1.77; 95% CI = 1.08–2.89; p = 0.023 and OR = 1.20; 95% CI = 1.05–1.38; p = 0.008, respectively). In a non-urban Mediterranean population, prediabetes was associated with established subclinical carotid atherosclerosis. These findings could have implications for the prevention and treatment of CV risk in these subjects before the first symptoms of cardiovascular disease appear.</jats:p>

Leukocyte and Platelet Related Inflammatory Indicators and Risk of Carotid and Femoral Plaques: A Population-Based Cross-Sectional Study in Southeast China

“…Positive associations were reported between leukocytes (most frequently reported), monocytes, and risk of the presence of carotid atherosclerosis or plaques. 17,18,20,31,38 Similar with our results, 2 studies also showed that severity of carotid atherosclerosis was associated with concurrently increased count of multiple blood inflammatory indicators including total leukocytes, neutrophils, and monocytes. 39,40 However, there were also inconsistent results, 21 for example, one population-based medical screening study in Japan (3738 participants) reported that the leukocyte count did not correlate with carotid atherosclerosis, 19 and it was weakly correlated with cardio-ankle vascular index in men.…”

“…Information for well-known or other potential confounders and mediators for atherosclerotic disease included demographics, lifestyle, and status of chronic diseases. 17,[31][32][33][34][35] Information regarding age, gender, education level, smoking, alcohol drinking, and family history of cardiovascular diseases was collected by trained interviewers using electronic, structured questionnaires. Cigarette smoking was defined as smoking ≥1 cigarette/day in the previous half a year.…”

Age-specific difference in the association between prediabetes and subclinical atherosclerosis: an analysis of a chinese prospective cohort study

“…It was reported previously that an increase in FPG within the normal range was associated with aggravated arterial stiffness in a cross-sectional study [ 21 ]. Another cross-sectional analysis of the ARIC study reported that prediabetes was associated with higher baPWV among older adults [ 22 ].…”

Cross-Sectional Association of Dietary Patterns and Supplement Intake with Presence and Gray-Scale Median of Carotid Plaques—A Comparison between Women and Men in the Population-Based Hamburg City Health Study

“…Several studies have shown that the presence of carotid plaques is particularly associated with older age, male sex [ 71 ] and smoking [ 72 ], but also linked to diseases such as hypercholesterolemia [ 31 ], hypertension, diabetes mellitus [ 73 , 74 ] and cardiac disease [ 75 ]. Our findings are in line with previous studies that revealed the following associations: In adjusted regression models, the odds of having at least one plaque significantly increased in men, older age, low education, arterial hypertension, hyperlipidemia and smoking status.…”

“…This suggests that cIMT and GSM may depict different aspects of atherosclerosis, with GSM relating more to metabolic aspects [ 28 ]. In addition to GSM, the presence of carotid plaque is associated with the incidence of CVD events [ 29 , 30 ] and is further an established ultrasound surrogate of CVD [ 31 , 32 ]. Nutritional aspects are known to play a relevant role in the development of atherosclerosis and in the formation of plaques [ 33 ].…”