Elevated 1-hour plasma glucose (1hPG) levels in persons without overt diabetes (DM) may be a marker for cardiovascular risk, according to the results of a study.
Pre-Diabetes identifies individuals with elevated fasting glucose or impaired glucose tolerance who may be at risk for DM, and it is also associated with increased risk for CVD and insulin resistance. 1hPG Levels during an OGTT may also be a risk indicator for CVD and Type 2 DM.
This is a cross-sectional study of patients with NGT and with pre-DM to examine the association between impaired 1-hour glucose tolerance and inflammatory markers and metabolic syndrome
Gianluca Bardini, MD, PhD, from the University of Florence in Italy, writes, "Pre-Diabetes identifies subjects with impaired fasting glucose ... and/or impaired glucose tolerance (IGT) at high risk for Type 2 diabetes (DM2); moreover, it is associated to insulin resistance ..., subclinical inflammation and cardiovascular diseases (CVD)." "Recently, 1-hour hyperglycemia (1hPG) during glucose tolerance test (OGTT) with a cut point of 155 mg/dl has been indicated as a further risk factor for DM2 and showed early carotid atherosclerosis."
The study goal was to evaluate metabolic characteristics and markers of inflammation in 1062 participants with normal glucose tolerance (NGT) and pre-DM. Fibrinogen and leukocytes count (WBC) for subclinical inflammation, lipid ratios, and insulin sensitivity measured with the Matsuda Index were compared in participants with or without 1hPG levels higher than 155 mg/dL after oral glucose loading.
Compared with participants with 1hPG levels of 155 mg/dL or lower, those with 1hPG levels higher than 155 mg/dL had significantly increased inflammatory markers and lipid ratios (P < .05 for all comparisons). An analysis adjusted for age, sex, and body mass index showed that 1hPG was associated with significantly increased WBC count and fibrinogen (P < .05). Compared with patients with 1hPG levels of 155 mg/dL or lower, those with 1hPG levels higher than 155 mg/dL had significantly lower insulin sensitivity (P < .01).
"Elevated 1hPG in NGT and pre-DM subjects is associated to subclinical inflammation, high lipid ratios and insulin resistance," the study authors write. "Therefore, 1hPG >155 mg/dl could be considered a new 'marker' for cardiovascular risk."
"It is well established that strict glycemic control (hemoglobin A1c <7.0%) can prevent the microvascular complications of diabetes mellitus. Recent studies indicate that elevated plasma glucose concentrations are an independent and clinically significant risk factor for cardiovascular disease in nondiabetic and diabetic individuals. Thus, isolated postprandial hyperglycemia (2-hour postprandial glucose level >140 mg/dL [>7.8 mmol/L]) in the face of normal fasting plasma glucose (<110 mg/dL [<6.1 mmol/L]) and normal hemoglobin A1c (<6.1%) values is associated with a 2-fold increased risk of death from cardiovascular disease. These observations imply that more strict glycemic control is required to prevent macrovascular disease than microvascular disease. This review summarizes epidemiologic and experimental studies linking postprandial hyperglycemia to cardiovascular disease and therapeutic approaches available and in development to treat this disorder."
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