1612-P: Liver Enzyme Is Associated with Future Remission from Impaired Fasting Glucose to Normal Fasting Glucose: The Kansai Healthcare Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1612-P
Author(s):  
IZUMI SHIBATA ◽  
KYOKO K. SATO ◽  
MIKIKO SHIBATA ◽  
HIDEO KOH ◽  
SHINICHIRO UEHARA ◽  
...  
Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Joshua J Joseph ◽  
Aleena Bennett ◽  
Justin B Echouffo Tcheugui ◽  
Valery S Effoe ◽  
James Odei ◽  
...  

Aims/hypothesis: Ideal cardiovascular health (ICH) is associated with lower risk of incident diabetes, but whether this association varies by baseline glycemia (normal [<100 mg/dL] vs. impaired fasting glucose [100-125 mg/dL]) remains to be clarified. We assessed the incidence of diabetes based on American Heart Association (AHA) ICH components stratified by glycemic status to determine whether ICH is more effective for primordial or primary prevention of diabetes among middle-aged and older adults. Methods: This study included 7,662 non-Hispanic whites and African Americans from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study without prevalent diabetes at baseline (2003-2006), who completed the follow-up exam (2013-2016). Participants were categorized as having ideal, intermediate or poor cardiovascular health, as defined by the AHA 2020 Impact Goals, based on baseline ICH components (total cholesterol, blood pressure, dietary intake, tobacco use, physical activity and body-mass index (BMI)). We categorized participants based on their total number of components that were ideal (0-1 “poor”, 2-3 “intermediate”, and 4+ “ideal”). Incident rate ratios (IRR) were calculated using modified poisson regression adjusting for age, sex, education, income, race, alcohol use, estimated glomerular filtration rate, urine albumin:creatinine ratio and high-sensitivity C-reactive protein. After confirming significant interactions with multiplicative interaction terms and application of likelihood ratio test, we stratified by glycemic status (normal vs. impaired fasting glucose). Results: Among REGARDS participants (mean age 63.0 [SD 8.4] years, 56% female, 26% African American), there were 560 incident diabetes cases (median follow-up 9.5 years). Overall, those with 2-3 and 4+ ICH components vs. 0-1 components had 31% (IRR 0.69; 95% CI 0.61, 0.79) and 71% lower (IRR 0.29; 95% CI 0.20, 0.42) risk of diabetes, respectively. Among 5,930 participants with normal fasting glucose, these risks were 36% (IRR 0.64; 95% CI 0.52, 0.79) and 80% lower (IRR 0.20; 95% CI 0.10, 0.37), while among 1,732 participants with baseline impaired fasting glucose these risks were 8% (IRR 0.92; 95% CI 0.80,1.07) and 13% lower (IRR 0.87; 95% CI 0.58,1.30) (p for interaction by baseline glucose status <0.0001). Conclusions/interpretation: Meeting an increasing number of ideal levels of dietary intake, physical activity, smoking, blood pressure, cholesterol and BMI was associated with a dose-dependent lower risk of diabetes for individuals with normal fasting glucose but not impaired fasting glucose. This suggests the AHA 2020 guidelines may be more effective for primordial versus primary prevention of diabetes among middle-aged and older adults.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
E. Leiva ◽  
V. Mujica ◽  
R. Orrego ◽  
S. Wehinger ◽  
A. Soto ◽  
...  

Aim. To study the evolution of impaired fasting glucose (IFG), considering glucose and HbA1c levels and risk factors associated, in a period of 6 years.Methods. We studied 94 subjects with impaired fasting glucose (IFG) that were diagnosed in 2005 and followed up to 2012. Glucose and HbA1c levels were determined. A descriptive analysis of contingence charts was performed in order to study the evolution in the development of type-2 diabetes mellitus (T2DM).Results. Twenty-eight of ninety-four subjects became T2DM; 51/94 remained with IFG; and 20/94 presented normal fasting glucose. From the 28 diabetic subjects, 9 had already developed diabetes and were under treatment with oral hypoglycemic agents; 5 were diagnosed with plasma glucose < 126 mg/dL, but with HbA1c over 6.5%. In those who developed diabetes, 15/28 had a family history of T2DM in first relative degree. Also, diabetic subjects had a BMI significantly higher than nodiabetics (ttest:P< 0.01). The individuals that in 2005 had the highest BMI are those who currently have diabetes.Conclusion. The IFG constitutes a condition of high risk of developing T2DM in a few years, especially over 110 mg/dL and in obesity patients.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Richard B Stacey ◽  
Paul E Leaverton ◽  
Douglas D Schocken ◽  
Alain G Bertoni

Background: It has been estimated that approximately 25% of initial myocardial infarctions (MI) are unrecognized (UMI). The prognostic implications of UMI’s have been shown to be as severe as those of symptomatic MI’s. Risk factors for UMI’s are not well understood. Because diabetes mellitus is known to be a risk factor for UMI, it is reasonable to investigate impaired fasting glucose (IFG) as a candidate risk factor. Additionally, it has recently been estimated that up to one-third of all adult Americans have IFG. Methods: The relationship between IFG and UMI was examined in the Multi-Ethnic Study of Atherosclerosis (MESA): a cohort of individuals aged 45 to 84 years without clinical cardiovascular disease. At baseline, participants with normal fasting glucose (NFG; n = 4955) and IFG (n=930) underwent a baseline 12-lead electrocardiogram (ECG). Using Minnesota code, an UMI was identified by the presence of pathological Q waves or minor Q waves with ST-T abnormalities. Crude and adjusted odds ratios (ORs) were calculated. Logistic regression was used to adjust for covariates in 2 models. Model 1 adjusted for age, race, gender, and body mass index. Model 2 adjusted for model 1 + systolic blood pressure, diastolic blood pressure, anti-hypertensive medication use, total cholesterol, HDL cholesterol, lipid-lowering medication use, and cigarette use. Results: The sample was 46% male, 41% white, 26% black, 20% Hispanic, and 12% Asian. There were 72 UMIs identified in the normal fasting glucose (NFG) subjects and 30 UMIs among the IFG subjects. The two corresponding prevalences (1.4% vs. 3.2%) resulted in a crude OR for UMI of 2.26 (95% Confidence Interval (CI): 1.47-3.48; p<0.001). With model 1 adjustments, the OR for UMI in IFG compared with NFG was 1.78 (95% CI: 1.12-2.8; p=0.015). With further adjustments in model 2, this relationship remained significant (OR: 1.63 (95% CI: 1.02-2.56); p=0.041). Conclusion: Unrecognized myocardial infarctions by electrocardiogram are associated with impaired fasting glucose in a population without overt cardiovascular disease. Because of the high prevalence of impaired fasting glucose, the implications of this finding may have ramifications for a large proportion of the adult population.


2018 ◽  
Vol 15 (4) ◽  
pp. 360-363
Author(s):  
Minjoo Kim ◽  
Minkyung Kim ◽  
Hye Jin Yoo ◽  
Yao Sun ◽  
Sang-Hyun Lee ◽  
...  

Both the peroxisome proliferator-activated receptor delta gene ( PPARD) and malondialdehyde plasma concentrations may play a role in impaired glucose metabolism. The aim of this work was to determine whether PPARD is a candidate gene for impaired fasting glucose or type 2 diabetes and whether a particular genetic variant shows association with plasma malondialdehyde levels. Among the 10 single-nucleotide polymorphisms that were most strongly associated with malondialdehyde, the rs7770619 polymorphism in PPARD was analysed in 1798 subjects with normal fasting glucose, impaired fasting glucose and newly diagnosed type 2 diabetes. Our data demonstrate that the CT genotype of the rs7770619 is associated with a lower risk of impaired fasting glucose or type 2 diabetes together with lower plasma levels of malondialdehyde in both groups ( p < 0.05). Glucose levels and the rs7770619 are significantly associated in individuals with normal fasting glucose, and a trend towards an association between glucose levels and rs7770619 is also observed in individuals with impaired fasting glucose or type 2 diabetes. In conclusion, PPARD rs7770619 is a novel candidate variant for impaired fasting glucose and type 2 diabetes and shows association with malondialdehyde levels. Future work is required to understand the mechanisms for these associations and the clinical implications of our findings.


2019 ◽  
Author(s):  
Nahid Hashemi Madani ◽  
Faramarz Ismail-Beigi ◽  
Hossein Poustchi ◽  
Mahdi Nalini ◽  
Sadaf G. Sepanlou ◽  
...  

Abstract Background Whether pre-diabetes in the absence of hypertension (HTN) or dyslipidemia (DLP) is a risk factor for occurrence of major adverse cardiovascular events (MACE) is not fully established. We investigated the effect of impaired fasting glucose (IFG) alone and in combination with HTN, DLP or both on subsequent occurrence of MACE as well as individual MACE components. Methods This longitudinal population-based study included 9,831 inhabitants of Northeastern Iran. The participants were free of any cardiovascular disease at baseline and were followed yearly from 2010 to 2017. Cox proportional hazard models were fitted to measure the hazard of IFG alone or in combination with HTN and DLP on occurrence of MACE as the primary endpoint. Results 297 MACE were recorded during 6.2±0.1 years follow up. IFG alone compared to normal fasting glucose (NFG) was not associated with increased in occurrence of MACE (HR, 1.05; 95% CI, 0.59-1.86; p, 0.8). However, combination of IFG and HTN (HR, 2.75; 95% CI, 1.93-3.90; p, 0.001) or HTN + DLP (HR, 2.85; 95% CI, 1.79-4.54; p, 0.001) significantly increased the hazard of MACE. In contrast, IFG with DLP at baseline did not increase the hazard of MACE compared to normoglycemic- normolipemic individuals (p,0.2). The results also indicated IFG with HTN, DLP, or HTN+DLP were associated with significant higher HRs for some individual components of MACE. Conclusion IFG, per se, does not appear to increase hazard of MACE. However, IFG with HTN or HTN + DLP conferred a significant hazard for MACE in an incremental manner.


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