Subclinical Atherosclerosis Among Individuals with Pre-diabetes

Abstract

Pre-diabetes is a stage between normoglycemia and diabetes mellitus. Subclinical atherosclerosis is not adequately explored among pre-diabetes in local setting. Carotid artery intima media thickness (CIMT) and elevated high sensitivity C-reactive protein (hsCRP) are recognized surrogates of subclinical atherosclerosis and inflammation, respectively.Present study investigated the excistanceof subclinical atherosclerosis and inflammation among persons with pre-diabetes compared to those with normal glucose tolerance. Healthy adults, aged 20-65years were screened with 75g-Oral glucose tolerance test (OGTT). Anthropometric measurements, fasting blood sugar (FBS), lipid profile, hsCRP and CIMT (in anterior and posterior walls of both common carotid arteries using duplex ultrasound) were compared in 101 individuals with impaired glucose tolerance (pre-diabetes) and 29 individuals with normal glucose tolerance. Mean (±SD) age of normoglycemia (n=29) and pre-diabetes (n=101) were 44(±8) and 45(±8) years, respectively. Mean(±SD) of body mass index, systolic blood pressure, dyastolic blood pressure, Hs CRP, total cholesterol, right anterior and left anterior CIMTs were not different between participants with normoglycemia and pre-diabetes [{ 25.7 (4.5), 25.8 (4.2), p=0.88};{120 (11), 124 (12), p=0.13};{76 (9),78 (7), p=0.26};{3.1 (3.4), 3.4 (3.5), p=0.71};{ 213 (38), 211 (45), p=0.86};{0.538 (0.11), 0.564 (0.11), p=0.29}; { 0.561 (0.09), 0.551 (0.11),p=0.67}] respectively. Right and left posterior wall CIMTs were significantly different between individuals with normoglycemia and pre-diabetes [{0.522mm (0.11), 0.578 mm (0.11), p=0.016}; {0.529 (0.11), 0.578 (0.13), p=0.051]. This study shows significantly increased right and left posterior CIMTs among pre-diabetes compared to normoglycemic participants. It provides evidence for the excistance of subclinical atherosclerosis in pre-diabetes requiring early intervention to reduce adverse atherosclerotic cardiovascular outcomes.