TY - JOUR
T1 - Glycemic and metabolic sub-classification of prediabetes and risk factors for cardiovascular disease in the D2d cohort
AU - D2d Research Group
AU - Kashyap, Sangeeta R.
AU - Desouza, Cyrus
AU - Aroda, Vanita R.
AU - Kim, Sun H.
AU - Neff, Lisa M.
AU - Wu, Shannon S.
AU - Raskin, Philip
AU - Pratley, Richard
N1 - Funding Information:
The conduct of D2d is primarily supported by NIDDK and the Office of Dietary Supplements of the National Institutes of Health through the multicenter clinical study cooperative agreement (U01DK098245; principal investigator A.G.P.) to Tufts Medical Center where the D2d Coordinating Center is based. The U01 grant mechanism establishes the NIDDK project scientist (M.A.S.) as a member of the D2d Research Group. The study also received secondary funding from the American Diabetes Association (1–14-D2d- 01). The D2d investigators and the NIDDK project scientist had a role in the design and conduct of the parent study. The funder had no role in this analysis.
Publisher Copyright:
© 2023
PY - 2023/9
Y1 - 2023/9
N2 - Objectives: Prediabetes represents a spectrum of metabolic abnormalities, including insulin resistance and secretory impairment, that carries increased cardiovascular disease (CVD) risk. It is unclear whether specific glycemic and metabolic sub-classifications are associated with CVD risk. This cross-sectional analysis of 3946 participants from the Vitamin D and Type 2 Diabetes (D2d) study cohort aimed to determine the associations between various baseline CVD risk factors, glycemic sub-classifications of prediabetes (FPG, 2hPG, and HbA1c), and measures of insulin sensitivity and secretion from an OGTT. Methods: The metabolic syndrome and atherosclerotic cardiovascular disease (ASCVD) risk scores were determined for tertiles of insulin sensitivity (HOMA2S) and insulinogenic index (IGI). Unadjusted analyses showed elevated CVD risk factors in the lowest tertile for both IGI and HOMA2S. Results: After adjustment for age, gender, race, obesity, and smoking status, the association remained between HOMA2S and ASCVD score (r = -0.11, p< 0.001) but not for IGI. Those who met at least 2 diagnosic criteria for prediabetes had the largest proportion (> 40%) of participants with high ASCVD risk score >20. A higher percentage of individuals that met all 3 criteria for prediabetes had metabolic syndrome and ASCVD risk score >20 (87.2% and 15.3%, respectively) than those who only met 1 prediabetes criterion (51.6% and 7.1%, respectively). Conclusions: In conclusion, multiple metabolic (HOMA2S, IGI) and glycemic criteria of prediabetes (FPG, 2hPG, & HbA1c) are needed to fully recognize the elevated CVD risk profile that can manifest in prediabetes.
AB - Objectives: Prediabetes represents a spectrum of metabolic abnormalities, including insulin resistance and secretory impairment, that carries increased cardiovascular disease (CVD) risk. It is unclear whether specific glycemic and metabolic sub-classifications are associated with CVD risk. This cross-sectional analysis of 3946 participants from the Vitamin D and Type 2 Diabetes (D2d) study cohort aimed to determine the associations between various baseline CVD risk factors, glycemic sub-classifications of prediabetes (FPG, 2hPG, and HbA1c), and measures of insulin sensitivity and secretion from an OGTT. Methods: The metabolic syndrome and atherosclerotic cardiovascular disease (ASCVD) risk scores were determined for tertiles of insulin sensitivity (HOMA2S) and insulinogenic index (IGI). Unadjusted analyses showed elevated CVD risk factors in the lowest tertile for both IGI and HOMA2S. Results: After adjustment for age, gender, race, obesity, and smoking status, the association remained between HOMA2S and ASCVD score (r = -0.11, p< 0.001) but not for IGI. Those who met at least 2 diagnosic criteria for prediabetes had the largest proportion (> 40%) of participants with high ASCVD risk score >20. A higher percentage of individuals that met all 3 criteria for prediabetes had metabolic syndrome and ASCVD risk score >20 (87.2% and 15.3%, respectively) than those who only met 1 prediabetes criterion (51.6% and 7.1%, respectively). Conclusions: In conclusion, multiple metabolic (HOMA2S, IGI) and glycemic criteria of prediabetes (FPG, 2hPG, & HbA1c) are needed to fully recognize the elevated CVD risk profile that can manifest in prediabetes.
KW - Cardiovascular disease
KW - Diabetes
KW - Insulin resistance
KW - Insulin secretion
KW - Insulin sensitivity
KW - Obesity
KW - Prediabetes
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U2 - 10.1016/j.ajpc.2023.100525
DO - 10.1016/j.ajpc.2023.100525
M3 - Article
C2 - 37650052
AN - SCOPUS:85168011907
SN - 2666-6677
VL - 15
JO - American Journal of Preventive Cardiology
JF - American Journal of Preventive Cardiology
M1 - 100525
ER -