Fasting glucose levels, incident diabetes, subclinical atherosclerosis and cardiovascular events in apparently healthy adults: A 12-year longitudinal study

Diab Vasc Dis Res. 2016 Nov;13(6):429-437. doi: 10.1177/1479164116653356. Epub 2016 Aug 2.

Abstract

We aimed to study the association between fasting plasma glucose, diabetes incidence and cardiovascular burden after 10-12 years. We evaluated diabetes and cardiovascular events incidences, carotid intima-media thickness and coronary artery calcium scores in ELSA-Brasil (the Brazilian Longitudinal Study of Adult Health) baseline (2008-2010) of 1536 adults without diabetes in 1998. We used regression models to estimate association with carotid intima-media thickness (in mm), coronary artery calcium scores (in Agatston points) and cardiovascular events according to fasting plasma glucose in 1998. Adjusted diabetes incidence rate was 9.8/1000 person-years (95% confidence interval: 7.7-13.6/1000 person-years). Incident diabetes was positively associated with higher fasting plasma glucose. Fasting plasma glucose levels 110-125 mg/dL were associated with higher carotid intima-media thickness (β = 0.028; 95% confidence interval: 0.003-0.053). Excluding those with incident diabetes, there was a borderline association between higher carotid intima-media thickness and fasting plasma glucose 110-125 mg/dL (β = 0.030; 95% confidence interval: -0.005 to 0.065). Incident diabetes was associated with higher carotid intima-media thickness (β = 0.034; 95% confidence interval: 0.015-0.053), coronary artery calcium scores ⩾400 (odds ratio = 2.84; 95% confidence interval: 1.17-6.91) and the combined outcome of a coronary artery calcium scores ⩾400 or incident cardiovascular event (odds ratio = 3.50; 95% confidence interval: 1.60-7.65). In conclusion, fasting plasma glucose in 1998 and incident diabetes were associated with higher cardiovascular burden.

Keywords: Epidemiology; atherosclerosis; carotid ultrasound; coronary artery calcium; type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asymptomatic Diseases
  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • Brazil / epidemiology
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / epidemiology*
  • Carotid Intima-Media Thickness
  • Chi-Square Distribution
  • Computed Tomography Angiography
  • Coronary Angiography / methods
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / epidemiology*
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology*
  • Fasting / blood*
  • Female
  • Humans
  • Incidence
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Odds Ratio
  • Prognosis
  • Proportional Hazards Models
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / epidemiology*
  • Young Adult

Substances

  • Biomarkers
  • Blood Glucose