Nontraditional atherosclerotic risk factors and extent of coronary atherosclerosis in patients with combined impaired fasting glucose and impaired glucose tolerance

ObjectiveImpaired fasting glucose (IFG) and impaired glucose tolerance (IGT) may convey disparate risks of metabolic consequences. Fasting plasma glucose (FPG), while an expedient screening procedure, may not adequately assess metabolic risk, particularly among youths. In order to inform a strategy for screening Chinese youth for pre-diabetes, we examined the relative value of IFG versus IGT to define metabolic risk by assessing their association with insulin resistance, beta-cell dysfunction, adverse adipokine profiles and other cardiometabolic risk factors.Research design and methodsWe recruited 542 subjects (age 14–28 years) from the Beijing Child and Adolescent Metabolic Syndrome study for an in-depth assessment of cardiometabolic risk factors, including a 2-hour oral glucose tolerance test, liver ultrasound and serum levels of four adipokines.ResultsFPG failed to identify nearly all (32/33) youths with IGT, whereas 2-hour plasma glucose (2 h PG) missed 80.8% (21/26) of subjects with IFG. Impaired beta-cell function was evident from decreased oral disposition indices in those with isolated impaired fasting glucose (iIFG) or isolated impaired glucose tolerance (iIGT) versus normal glucose tolerance (NGT) (all p<0.001), whereas reduced insulin sensitivity (Matsuda) index was most pronounced in the iIGT group (p<0.01). Moreover, alterations in adipokine levels (fibroblast growth factor 21, adiponectin and leptin/adiponectin ratio) were associated with iIGT (p<0.05) but not iIFG. Youths with iIGT had a 2-fold to 32-fold increased incidence of hypertriglyceridemia, hypertension and metabolic syndrome (MetS) compared with those with NGT. In addition, subgroup analyses of participants with normal FPG revealed that the odds of having IGT increased 3-fold to 18-fold among those with elevated TGs, hypertension, moderate-to-severe non-alcoholic fatty liver disease or MetS.ConclusionsChinese youth with iIGT exhibit a higher cardiometabolic risk profile than those with iIFG. Thus, 2 h PG is preferred over FPG to identify the pre-diabetes phenotype at greatest risk of subsequent development of cardiovascular disease.Trial registration numberNCT03421444.

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Toward targeted prevention: risk factors for prediabetes defined by impaired fasting glucose, impaired glucose tolerance and increased HbA1c in the population-based KORA study from Germany

Acta Diabetologica ◽

10.1007/s00592-020-01573-x ◽

2020 ◽

Vol 57 (12) ◽

pp. 1481-1491

Author(s):

Gregory G. Greiner ◽

Karl M. F. Emmert-Fees ◽

Jana Becker ◽

Wolfgang Rathmann ◽

Barbara Thorand ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Impaired Fasting Glucose ◽

Fasting Glucose ◽

Population Based ◽

Targeted Prevention ◽

Explanatory Variables ◽

Obesity Hypertension

Abstract Aims To identify socioeconomic, behavioral and clinical factors that are associated with prediabetes according to different prediabetes definition criteria. Methods Analyses use pooled data of the population-based Cooperative Health Research in the Region of Augsburg (KORA) studies (n = 5312 observations aged ≥ 38 years without diabetes). Prediabetes was defined through either impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or elevated HbA1c according to thresholds of the American Diabetes Association. Explanatory variables were regressed on prediabetes using generalized estimating equations. Results Mean age was 58.4 years; 50% had prediabetes (33% had IFG, 16% IGT, and 26% elevated HbA1c, 10% fulfilled all three criteria). Age, obesity, hypertension, low education, unemployment, statutory health insurance, urban residence and physical inactivity were associated with prediabetes. Male sex was a stronger risk factor for IFG (OR = 2.5; 95%–CI: 2.2–2.9) than for IGT or elevated HbA1c, and being unemployed was a stronger risk factor for IGT (OR = 3.2 95%–CI: 2.6–4.0) than for IFG or elevated HbA1c. Conclusions The overlap of people with IFG, IGT and elevated HbA1c is small, and some factors are associated with only one criterion. Knowledge on sociodemographic and socioeconomic risk factors can be used to effectively target interventions to people at high risk for type 2 diabetes.

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Differential impact of impaired fasting glucose versus impaired glucose tolerance on cardiometabolic risk factors in multi-ethnic overweight/obese children

European Journal of Pediatrics ◽

10.1007/s00431-010-1323-3 ◽

2010 ◽

Vol 170 (5) ◽

pp. 589-597 ◽

Cited By ~ 9

Author(s):

Mariska van Vliet ◽

Roel P. Gazendam ◽

Inès A. von Rosenstiel ◽

Anton P. van Zanten ◽

Desiderius P. M. Brandjes ◽

...

Keyword(s):

Risk Factors ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Impaired Fasting Glucose ◽

Cardiometabolic Risk ◽

Fasting Glucose ◽

Cardiometabolic Risk Factors ◽

Obese Children ◽

Differential Impact

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Differential clusters of modifiable risk factors for impaired fasting glucose versus impaired glucose tolerance in adults 50 years of age and older

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622319854239 ◽

2019 ◽

Vol 10 ◽

pp. 204062231985423

Author(s):

Ahmed Ghachem ◽

Martin Brochu ◽

Isabelle J. Dionne

Keyword(s):

Risk Factors ◽

Body Composition ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Impaired Fasting Glucose ◽

Fasting Glucose ◽

Dietary Factors ◽

Modifiable Risk Factors ◽

Men And Women ◽

Total Fat

Background: The aim of this study was to identify modifiable risk factors associated with isolated impaired fasting glucose (IFG), isolate impaired glucose tolerance (IGT), or combined IFG-IGT in men and women aged 50 years and older. Methods: Cross-sectional analyses were performed in 703 men and women aged between 50 and 80 years old from NHANES (2007–2008). Outcome variables: IFG and IGT (ADA 2003), estimated body composition, cardiometabolic profile, and socio-demographic, dietary, and lifestyle factors. Results: First, 235 had normal glucose tolerance (men = 38.3%, women = 61.7%), 243 had IFG (men = 61.7%, women = 38.3%), 67 had IGT (men = 40.3%, women = 59.7%) and 158 had both conditions (men = 57.0%, women = 43.0%). The only common determinant of both IFG and IGT was triglyceride levels. High total fat mass index (FMI) and high total fat-free mass index (FFMI) were independently associated with IFG; while high C-reactive protein (CRP) levels were independently associated with IGT. Finally, combined IFG-IGT was associated with inadequate fiber intake, high FMI, FFMI, and CRP levels. Conclusions: Middle-age and older individuals presented different modifiable risk factors depending on whether they had IFG or IGT. IFG was associated with deteriorated body composition and lipids, whereas IGT was associated with deteriorated lipids and inflammatory factors. IFG-IGT, on the other hand, was associated with a larger number of risk factors, including worsen body composition, cardiometabolic and dietary factors. To prevent the transition to type 2 diabetes, specific clinical interventions targeting these risk factors should be considered.

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Faculty of 1000 evaluation for Effects of Pioglitazone on Bone in Postmenopausal Women With Impaired Fasting Glucose or Impaired Glucose Tolerance: A Randomized, Double-Blind, Placebo-Controlled Study.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.718116491.793485173 ◽

2013 ◽

Author(s):

John Eisman

Keyword(s):

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Postmenopausal Women ◽

Impaired Fasting Glucose ◽

Fasting Glucose ◽

Controlled Study ◽

Double Blind ◽

Double Blind Placebo

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Progression to and Prevention of Diabetes: Disparity of Impaired Fasting Glucose and Impaired Glucose Tolerance - Review Article

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.08.11222 ◽

2020 ◽

Vol 103 (8) ◽

pp. 829-836

Keyword(s):

High Risk ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Lifestyle Intervention ◽

Impaired Fasting Glucose ◽

Diabetes Prevention ◽

Lifestyle Modification ◽

Fasting Glucose ◽

World Health ◽

Risk Of Progression

It is well established that individuals who have prediabetes either impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) have high risk to develop diabetes. However, it is unclear whether the rate of progression to diabetes is different between these two categories. Lifestyle modification has been recommended for diabetes prevention in these high-risk groups. However, given the differences in their pathophysiology, it is possible that these subtypes of prediabetes condition may have different responses to lifestyle modification. The present review was to summarize the risk of progression to diabetes and the effectiveness of lifestyle intervention for diabetes prevention in individuals who have isolated IGT or isolated IFG or combined. The risk of progression to diabetes is highest in combined IFG and IGT subtype. Individuals who have isolated IFG by the American Diabetes Association criteria (100 to 125 mg/dl) has lower risk of progression to diabetes than those with World Health Organization criteria (110 to 125 mg/dl) and the latter has similar or higher risk of incident diabetes than those with isolated IGT. Lifestyle modification is most effective in individuals with IGT (with or without IFG) but is less effective in those with isolated IFG. In conclusion, The risk of progression to diabetes and the effectiveness of lifestyle intervention for diabetes prevention are disparate between prediabetes subtypes. Given the paucity of diabetes prevention data in individuals with isolated IFG, more studies dedicated to this subtype is required. Keywords: Impaired fasting glucose, Impaired glucose tolerance, Prediabetes, Type 2 diabetes, Lifestyle intervention, Diabetes prevention

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