Characteristics of atheromatosis in the prediabetes stage : A cross-sectional investigation of the ILERVAS project
Sánchez, Enric (Hospital Arnau de Vilanova (Lleida, Catalunya))
Betriu, Àngels (Instituto de Salud Carlos III)
López-Cano, Carolina (Hospital Arnau de Vilanova (Lleida, Catalunya))
Hernández, Marta (Hospital Arnau de Vilanova (Lleida, Catalunya))
Fernández, Elvira (Instituto de Salud Carlos III)
Purroy, Francisco (Institut de Recerca Biomèdica de Lleida)
Bermúdez-López, Marcelino (Instituto de Salud Carlos III)
Farràs-Sallés, Cristina (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Barril, Silvia (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Pamplona, Reinald (Universitat de Lleida. Departament de Medicina Experimental)
Rius, Ferran (Hospital Arnau de Vilanova (Lleida, Catalunya))
Hernández, Cristina (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Simó Canonge, Rafael (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Lecube, Albert (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)

Fecha:	2019
Resumen:	Background: Prediabetes has recently been associated with subclinical atheromatous disease in the middle-aged population. Our aim was to characterize atheromatous plaque burden by the number of affected territories and the total plaque area in the prediabetes stage. Methods: Atheromatous plaque burden (quantity of plaques and total plaque area) was assessed in 12 territories from the carotid and femoral regions using ultrasonography in 6688 non-diabetic middle-aged subjects without cardiovascular disease. Prediabetes was defined by glycosylated hemoglobin (HbA1c) between 5. 7 and 6. 4% according to the American Diabetes Association guidelines. Results: Prediabetes was diagnosed in 33. 9% (n = 2269) of the ILERVAS participants. Subjects with prediabetes presented a higher prevalence of subclinical atheromatous disease than participants with HbA1c < 5. 7% (70. 4 vs. 67. 5%, p = 0. 017). In the population with prediabetes this was observed at the level of the carotid territory (p < 0. 001), but not in the femoral arteries. Participants in the prediabetes stage also presented a significantly higher number of affected territories (2 [1;3] vs. 1 [0;3], p = 0. 002), with a positive correlation between HbA1c levels and the number of affected territories (r = 0. 068, p < 0. 001). However, atheromatosis was only significantly (p = 0. 016) magnified by prediabetes in those subjects with 3 or more cardiovascular risk factors. The multivariable logistic regression model showed that the well-established cardiovascular risk factors together with HbA1c were independently associated with the presence of atheromatous disease in participants with prediabetes. When males and females were analyzed separately, we found that only men with prediabetes presented both carotid and femoral atherosclerosis, as well as an increase of total plaque area in comparison with non-prediabetic subjects. Conclusions: The prediabetes stage is accompanied by an increased subclinical atheromatous disease only in the presence of other cardiovascular risk factors. Prediabetes modulates the atherogenic effect of cardiovascular risk factors in terms of distribution and total plaque area in a sex-dependent manner.
Ayudas:	Agència de Gestió d'Ajuts Universitaris i de Recerca 2017SGR696 Agència de Gestió d'Ajuts Universitaris i de Recerca SLT0021600250
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Cardiovascular risk factors ; Glycosylated hemoglobin ; Subclinical atheromatous disease ; Prediabetes
Publicado en:	Cardiovascular diabetology, Vol. 18 Núm. 154 (11 2019) , ISSN 1475-2840

DOI: 10.1186/s12933-019-0962-6
PMID: 31729979

12 p, 1.1 MB

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