Risk for diabetes and persistent impaired glucose tolerance among middle-aged Finns

The aim of the study was to evaluate the occurrence of atheromatous plaques in carotid, aortic and femoral arteries, focusing on blood pressure (BP). The study subjects consisted of 65-year-old Finns drawn from a population-based cohort. Ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance (IGT) and 57 normoglycaemic subjects (NGT). High systolic BP (SBP) was defined as X160 mmHg and high diastolic BP as X95 mmHg. High pulse pressure (PP) was defined as the highest tertile (X75 mmHg) of PP and high mean BP (MBP) as the highest tertile (X111 mmHg) of MBP. The prevalence of atheromatous plaques was 77% (160/208) in carotid arteries, 94% (195/208) in aorta and 77% (161/ 208) in femoral arteries. A total of 64% (134/208) of the subjects had plaques in both carotid and femoral arteries, and they were compared with those who had plaques in 0-1 of these arteries. In addition to male gender and long-lasting smoking, the occurrence of plaques in both carotid and femoral arteries were associated with high SBP and high MBP. According to the results of multiple regression analyses, the adjusted odds ratio for plaques in both carotid and femoral arteries was 3.1 (95% CI 1.5-6.5) in subjects with high SBP compared to those with lower SBP. When SBP was replaced by high MBP, the adjusted odds ratio for it was 2.3 (95% CI 1.1-4.8).

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“…In 1994 and 1996-1998, two follow-up studies were carried out. 17,21,22 OGTTs were performed at these follow-up visits.…”

Section: Methodsmentioning

confidence: 99%

Blood pressure and atherosclerotic plaques in carotid, aortic and femoral arteries in elderly Finns with diabetes mellitus or impaired glucose tolerance

et al. 2004

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“…In 1994 and 1996-1998, two follow-up studies were carried out. 24,26,27 OGTTs were performed at these followup visits.…”

Section: Methodsmentioning

confidence: 99%

Associations of blood pressure with carotid intima-media thickness in elderly Finns with diabetes mellitus or impaired glucose tolerance

et al. 2003

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The aim of the present study was to evaluate the associations of ultrasonographic manifestations of carotid atherosclerosis with systolic (SBP) and diastolic blood pressure (DBP) and pulse pressure (PP) in 65-year-old Finns drawn from a population-based cohort. Carotid ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance (IGT) and 57 normoglycaemic subjects (NGT). The subjects were classified into four quartiles of SBP, DBP and PP. SBP, DBP, PP and the use of antihypertensive drugs increased along with the deterioration of glucose status. The maximal intima-media thickness (IMT) of the common carotid artery (CCA) from the lowest to the highest quartiles of SBP was 0.98 7 0.34, 1.00 7 0.35, 1.03 7 0.29, 1.18 7 0.52 mm (P ¼ 0.038), respectively. SBP was higher (161 7 22 mmHg) in the subjects with severe intimamedia thickening (maximal IMT CCA X1.2 mm) than in those with maximal IMT CCA of o1.2 mm (153 7 20 mmHg) (P ¼ 0.030). DBP and PP tended to be higher in the former than the latter group (DBP: 89 7 9 mmHg vs 86 7 9 mmHg, P ¼ 0.055 and PP: 72 7 18 mmHg vs 67 7 17 mmHg, P ¼ 0.159). The prevalence of severe intima-media thickening was 39% in the subjects in the highest SBP quartile (X170 mmHg) and 20% in the subjects with lower SBP (P ¼ 0.008). In multiple regression analysis, the adjusted OR for severe intima-media thickening was 2.9 (95% CI 1.1-7.9) in the subjects in the highest SBP quartile compared to the subjects with lower SBP. In the present study, high SBP was associated with severe carotid intima-media thickening. We suggest that the results can be generalized to apply to elderly Finnish subjects with DM and IGT, but not to normoglycaemic subjects, on the basis of this study.

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“…3,4 In the Diabetes Prevention Program and the Diabetes Prevention Study it was shown that lifestyle intervention, including moderate weight loss, substantially reduced the risk of diabetes in high-risk subjects. 5,6 Although reversion to normal glucose tolerance (NGT) is not a rare event, 7,8 the effects of weight and weight change on reversion from prediabetes to NGT have been investigated much less. [9][10][11][12][13][14] Two of these studies focus on children and adolescents, 9,10 and the findings in the other four studies are rather inconclusive.…”

Section: Introductionmentioning

confidence: 99%

Impact of weight and weight change on normalization of prediabetes and on persistence of normal glucose tolerance in an older population: the KORA S4/F4 study

et al. 2011

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Background and aims: In a population-based cohort study with older subjects and without specific interventions, we investigated the impact of body mass index (BMI) and BMI change (as well as waist circumference and change of waist circumference) on reversion from prediabetes to normal glucose tolerance (NGT) and on long-term persistence of NGT. Materials and methods: Oral glucose tolerance tests were conducted at baseline and at follow-up in a cohort study in Southern Germany (KORA S4/F4; 1223 subjects without diabetes aged 55-74 years at baseline in 1999-2001; 887 subjects (73%), of whom 436 had prediabetes at baseline, participated in the follow-up 7 years later). Results: BMI reduction, but not initial BMI, predicted reversion from prediabetes to NGT. The odds ratio (OR) for returning to NGT was 1.43 (95% CI: 1.18-1.73) for a BMI decrease of 1 kg m À2 , after adjustment for age, sex, baseline glucose values and lifestyle factors. Initial BMI had no effect on reversion to NGT (OR ¼ 0.98, 95% CI: 0.91-1.06, per kg m À2 ). Persistence of NGT was associated with baseline BMI (OR ¼ 0.94, 95% CI: 0.88-0.998) and BMI reduction (OR ¼ 1.16, 95% CI: 1.02-1.33, per decrease by 1 kg m À2 ). For waist circumference and change of waist circumference similar results were obtained. Conclusion: In older adults, weight loss strongly increased the chances of returning from prediabetes to NGT irrespective of initial BMI. Long-term persistence of NGT depended both on initial BMI and on BMI change.

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Risk for diabetes and persistent impaired glucose tolerance among middle-aged Finns

Cited by 22 publications

References 36 publications

Blood pressure and atherosclerotic plaques in carotid, aortic and femoral arteries in elderly Finns with diabetes mellitus or impaired glucose tolerance

Blood pressure and atherosclerotic plaques in carotid, aortic and femoral arteries in elderly Finns with diabetes mellitus or impaired glucose tolerance

Associations of blood pressure with carotid intima-media thickness in elderly Finns with diabetes mellitus or impaired glucose tolerance

Impact of weight and weight change on normalization of prediabetes and on persistence of normal glucose tolerance in an older population: the KORA S4/F4 study

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