Fasting plasma glucose levels and coronary artery calcification in subjects with impaired fasting glucose

Abstract

BACKGROUND: Prediabetes is associated with an increased risk of cardiovascular disease (CVD). While the association of impaired glucose tolerance with CVD has been shown in many studies, the relationship between impaired fasting glucose (IFG) and CVD remains unclear. OBJECTIVES: The purpose of this study was to compare the coronary artery calcium (CAC) scores of participants with normal fasting glucose versus those with IFG, according to fasting plasma glucose (FPG) levels, and to assess whether differences in CAC scores were independent of important confounders. DESIGN: Retrospective study. SETTING: Health Promotion Center of the University Hospital (Gyeonggi-do, South Korea), during the period 2010-2014. PATIENTS AND METHODS: Participants were enrolled from the general population who visited for a medical check-up. CAC was assessed in asymptomatic individuals by multidetector computed tomography. Anthropometric parameters and metabolic profiles were also recorded. Subjects were divided into four fasting glucose groups. Participants with a history of CVD or diabetes mellitus were excluded. MAIN OUTCOME MEASURES: Correlation between FPG and CAC scores, CAC score categories, and association between CAC score and FPG categories. RESULTS: Of 1112 participants, 346 (34.2%) had a CAC score >0. FPG values in the IFG patients were positively but weakly correlated with CAC scores (r=0.099, P=.001). The incidence of CAC differed according to FPG level (P <120, OR=2.507, P=.002; 120≤FPG [mg/dL] <126, OR=3.568, P=.001 vs. <100 mg/dL) CONCLUSION: IFG (especially FPG≥110 mg/dL) could be an independent risk factor for CAC. These associations were not altered after adjustment for other possible confounders. LIMITATIONS: Possible misclassification because data taken from a single blood test. No HbA1c tests or repeated FPG tests. No adjustment for other potentially important confounders.