Cardiovascular Risk Among Saudi Adults with Prediabetes: A Sub-Cohort Analysis from the Heart Health Promotion (HHP) Study

Amel Fayed; Rasmieh Alzeidan; Samia Esmaeil; Hala Elmorshedy; Doaa Ismail; Roaa Elkouny; Hayfaa A Wahabi

doi:10.2147/IJGM.S374190

Cardiovascular Risk Among Saudi Adults with Prediabetes: A Sub-Cohort Analysis from the Heart Health Promotion (HHP) Study

Int J Gen Med. 2022 Aug 29:15:6861-6870. doi: 10.2147/IJGM.S374190. eCollection 2022.

Authors

Amel Fayed¹, Rasmieh Alzeidan², Samia Esmaeil³, Hala Elmorshedy¹, Doaa Ismail⁴, Roaa Elkouny⁵, Hayfaa A Wahabi^{3

6}

Affiliations

¹ College of Medicine, Clinical Department, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
² College of Medicine, Cardiac Sciences Department, King Saud University, Riyadh, Saudi Arabia.
³ Research Chair of Evidence-Based Healthcare and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia.
⁴ Department of Physical Medicine, Rheumatology & Rehabilitation, Tanta University, Faculty of Medicine, Tanta, Egypt.
⁵ College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
⁶ Department of Family and Community Medicine, King Saud University Medical City and College of Medicine, Riyadh, Saudi Arabia.

Abstract

Background: This study aimed to estimate the prevalence of prediabetes among Saudi adults and to evaluate their risk of developing cardiovascular diseases.

Methods: This is a cohort of 2470 Saudi adults attending employee clinics in the university hospital. WHO-STEPs approach was used to collect sociodemographic (age, gender, and education), clinical (body mass index and blood pressure) and laboratory data (HbA1c, lipid profile and vitamin D concentration). Prediabetes was defined according to HbA1c level of 5.7-6.4%. Cardiovascular risk (CVR) scores were evaluated using the Framingham Risk Score. SPSS was used for data analysis to investigate the relation between different CVR and prediabetes.

Results: Prediabetes affected 25.1% of the study population. Males had higher rates of prediabetes than females (27.5% versus 23.5%). The prevalence of prediabetes increased from 11.6% among young individuals (18-29 years) to 56.0% among participants 60 years and older. Prediabetes patients exhibited considerably higher levels of all cardiovascular risk factors and nearly half of them (49.3%) had at least two risk factors. The prevalence of intermediate CVR among prediabetics was 13.2% compared to just 2.9% among the normal group, and high CVR was defined in 3.7% among prediabetics compared to only 1.7% in the normal group. Having prediabetes increased the odds to develop higher CVR of 2.64 times compared to those without prediabetes (OR = 2.64, 95% CI = 1.51-4.64) and the level of vitamin D did not affect the odds of CVR.

Conclusion: Prediabetes is quite prevalent among Saudi adults, and they are at a higher risk of cardiovascular diseases. Patients with prediabetes have higher cardiac risk scores when compared to normal participants across the whole spectrum of (25(OH)D) concentrations. Additionally, no significant correlation was observed between HbA1c and (25(OH)D) levels in prediabetics or normoglycemic subjects.

Keywords: Framingham cardiovascular risk score; Saudi Arabia; cardiovascular risk; prediabetes.

Grants and funding

This project was funded by Princess Nourah bint Abdulrahman University researchers supporting project (number PNURSP2022R21) Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.