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Cardiovascular risk profile in subjects with prediabetes and new-onset type 2 diabetes identified by HbA(1c) according to American Diabetes Association criteria.
Diabetes Care. 2014 May; 37(5):1447-53.DC

Abstract

OBJECTIVE

We investigated the cardiovascular risk profile in subjects with prediabetes and new-onset type 2 diabetes identified by glycated hemoglobin A1c (HbA(1c)) according to the new American Diabetes Association criteria.

RESEARCH DESIGN AND METHODS

Arterial stiffness, intima-media thickness (IMT), soluble receptor for advanced glycation end products (sRAGEs), and oral glucose tolerance test (OGTT) were evaluated in 274 subjects without a previous history of diabetes. The subjects were stratified into three groups according to the HbA(1c) levels.

RESULTS

The subjects with prediabetes (n = 117, HbA(1c) 5.7-6.4% [39-46 mmol/mol]) showed a higher augmentation (Aug), augmentation index (AugI), and IMT compared with those with lower HbA1c; however, these values were similar to those of subjects with HbA(1c) >6.5% (48 mmol/mol). When we further analyzed the subjects with prediabetes but included only subjects with normal glucose tolerance (NT) in the analysis, AugI and IMT still remained significantly higher than their levels in control subjects with HbA(1c) <5.7% (39 mmol/mol). After multiple regression analyses including several cardiovascular risk factors, only HbA(1c), age, and sRAGE were significantly correlated with the IMT, whereas age and 1-h postload glucose were the major determinants of AugI.

CONCLUSIONS

Our data show that subjects with prediabetes according to HbA1c, but with both NT according to the OGTT and normal fasting glycemia, have an altered IMT and AugI. These data suggest that a simple, reproducible, and less expensive marker such as HbA1c may be better able to identify prediabetic subjects at high cardiovascular risk compared with fasting glycemia or OGTT alone.

Authors+Show Affiliations

Corresponding author: Francesco Purrello, fpurrell@unict.it.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24574348

Citation

Di Pino, Antonino, et al. "Cardiovascular Risk Profile in Subjects With Prediabetes and New-onset Type 2 Diabetes Identified By HbA(1c) According to American Diabetes Association Criteria." Diabetes Care, vol. 37, no. 5, 2014, pp. 1447-53.
Di Pino A, Scicali R, Calanna S, et al. Cardiovascular risk profile in subjects with prediabetes and new-onset type 2 diabetes identified by HbA(1c) according to American Diabetes Association criteria. Diabetes Care. 2014;37(5):1447-53.
Di Pino, A., Scicali, R., Calanna, S., Urbano, F., Mantegna, C., Rabuazzo, A. M., Purrello, F., & Piro, S. (2014). Cardiovascular risk profile in subjects with prediabetes and new-onset type 2 diabetes identified by HbA(1c) according to American Diabetes Association criteria. Diabetes Care, 37(5), 1447-53. https://doi.org/10.2337/dc13-2357
Di Pino A, et al. Cardiovascular Risk Profile in Subjects With Prediabetes and New-onset Type 2 Diabetes Identified By HbA(1c) According to American Diabetes Association Criteria. Diabetes Care. 2014;37(5):1447-53. PubMed PMID: 24574348.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular risk profile in subjects with prediabetes and new-onset type 2 diabetes identified by HbA(1c) according to American Diabetes Association criteria. AU - Di Pino,Antonino, AU - Scicali,Roberto, AU - Calanna,Salvatore, AU - Urbano,Francesca, AU - Mantegna,Concetta, AU - Rabuazzo,Agata Maria, AU - Purrello,Francesco, AU - Piro,Salvatore, Y1 - 2014/02/26/ PY - 2014/2/28/entrez PY - 2014/2/28/pubmed PY - 2015/4/30/medline SP - 1447 EP - 53 JF - Diabetes care JO - Diabetes Care VL - 37 IS - 5 N2 - OBJECTIVE: We investigated the cardiovascular risk profile in subjects with prediabetes and new-onset type 2 diabetes identified by glycated hemoglobin A1c (HbA(1c)) according to the new American Diabetes Association criteria. RESEARCH DESIGN AND METHODS: Arterial stiffness, intima-media thickness (IMT), soluble receptor for advanced glycation end products (sRAGEs), and oral glucose tolerance test (OGTT) were evaluated in 274 subjects without a previous history of diabetes. The subjects were stratified into three groups according to the HbA(1c) levels. RESULTS: The subjects with prediabetes (n = 117, HbA(1c) 5.7-6.4% [39-46 mmol/mol]) showed a higher augmentation (Aug), augmentation index (AugI), and IMT compared with those with lower HbA1c; however, these values were similar to those of subjects with HbA(1c) >6.5% (48 mmol/mol). When we further analyzed the subjects with prediabetes but included only subjects with normal glucose tolerance (NT) in the analysis, AugI and IMT still remained significantly higher than their levels in control subjects with HbA(1c) <5.7% (39 mmol/mol). After multiple regression analyses including several cardiovascular risk factors, only HbA(1c), age, and sRAGE were significantly correlated with the IMT, whereas age and 1-h postload glucose were the major determinants of AugI. CONCLUSIONS: Our data show that subjects with prediabetes according to HbA1c, but with both NT according to the OGTT and normal fasting glycemia, have an altered IMT and AugI. These data suggest that a simple, reproducible, and less expensive marker such as HbA1c may be better able to identify prediabetic subjects at high cardiovascular risk compared with fasting glycemia or OGTT alone. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/24574348/Cardiovascular_risk_profile_in_subjects_with_prediabetes_and_new_onset_type_2_diabetes_identified_by_HbA_1c__according_to_American_Diabetes_Association_criteria_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=24574348 DB - PRIME DP - Unbound Medicine ER -