Does a Lower Cut-Off Limit for Impaired Fasting Glucose Change the Global Cardiovascular Risk?
Abstract Number: 1008-P
Authors: CARSTA KOEHLER, FRANK SCHAPER, ELENA HENKEL, THEODORA TEMELKOVA-KURKTSCHIEV, MARKOLF HANEFELD
Institutions: Dresden, Germany
Results: The risk of cardiovascular diseases or diabetes appears to increase along a continuum for fasting glucose levels. The ADA now proposed to lower the cut-off limit for impaired fasting glucose (IFG) from 6.1 to 5.6mmol/l . We therefore analysed the question which implications has this decrease in the cut-off level for the cardiovascular risk burden. Probands were recruited from the Risk Factors in IGT for Atherosclerosis and Diabetes (RIAD) study which included subjects (n=460) with a risk to develop type 2 diabetes. By 75g OGTT the following subgroups were built up: IFG (6.1 to <7.0mmol/l fasting plasma glucose (PG) and 2h PG after OGTT<7.8mmol/l) (n=91), the lower IFG cut-off (lowIFG) (5.6 to <7.0mmol/l fasting plasma glucose (PG) and 2h PG after OGTT <7.8mmol/l) (n=239) and normoglycemic (NG) subjects (n=369 or n=221). Lipids, PG, HbA1C, real insulin were examined by routine methods. Insulin resistance (IR) was calculated by HOMA. The comparison among the cut-off limits was based on the area under the receiver operating characteristic (ROC) curve. The major risk indices for the groups IFG vs NG and lowIFG vs NG were as (mean (SD)): age 56.9( 7.5) vs 53.9(8.3) and 55.2(7.8) vs 53.8(8.5) yrs; BMI 27.6(3.9) vs 26.1(4.0) and 27.4(4.1) vs 25.3(3.7) kg/m2; HbA1C 5.7(0.5) vs 5.5(0.4) and 5.6(0.5) vs 5.4(0.4) %; triglycerides 1.9(1.6) vs 1.4(0.8) and 1.6(1.2) vs 1.4(0.9) mmol/l; total cholesterol 5.9(1.1) vs 5.8(1.0) and 5.8(1.1) vs 5.8 (1.1); systolic blood pressure 137(20) vs 132(18) and 136(19) vs 130(18) mmHg; IR 4.3(2.5) vs 2.8(2.2) and 3.8(2.9) vs 2.3(1.2). The area under ROC curves are similar in both IFG and the lower cut-off level of IFG. The previous shown significant differences in metabolic parameters between IFG and NG were also found between lowIFG and NG (P<0.001). Already at a lower cut-off level of IFG of 5.6 mmol/l the global cardiovascular risk is increased.