Association between markers of glycemia and carotid intima-media thickness: the MARK study

Manuel A Gomez-Marcos, Leticia Gomez-Sanchez, Maria C Patino-Alonso, Jose I Recio-Rodriguez, Natividad Garcia Regalado, Rafel Ramos, Ruth Marti, Cristina Agudo-Conde, Emiliano Rodriguez-Sanchez, Jose A Maderuelo-Fernandez, Luis Garcia-Ortiz, MARK Group, Manuel A Gomez-Marcos, Leticia Gomez-Sanchez, Maria C Patino-Alonso, Jose I Recio-Rodriguez, Natividad Garcia Regalado, Rafel Ramos, Ruth Marti, Cristina Agudo-Conde, Emiliano Rodriguez-Sanchez, Jose A Maderuelo-Fernandez, Luis Garcia-Ortiz, MARK Group

Abstract

Background: Carotid intima-media thickness (C-IMT) is a reliable predictor of cardiovascular events. We Investigated the relationship between markers of glycemia and C-IMT in intermediate-risk cardiovascular patients.

Methods: This study analyzed 427 subjects, aged 35 to 74 years (mean, 60.3 ± 8.5 years), 55 % women, enrolled into the MARK study. Including 231 subjects defined as normal glucose, 104 subjects classified as prediabetes and 92 with type 2 diabetes mellitus. Carotid ultrasound was used to measure C-IMT and the presence of plaques. Fasting plasma glucose (mg/dl) and glycated hemoglobin (%) (HbA1c) were measured using standard enzymatic automated methods. Postprandial glucose (mg/dl) was self-measured by patients at home 2 h after meals (breakfast, lunch and dinner) for 1 day.

Results: The C-IMT shows a positive correlation with fasting plasma glucose, postprandial glucose and HbA1c. Multiple linear regression analysis showed a positive association between HbA1c and C-IMT, with a 0.016 mm and 0.019 mm increase in mean and maximum C-IMT per 1 % increase in HbA1c. In addition, an association between fasting plasma glucose and C-IMT was found with an increase of 0.004 and 0.005 mm in mean and maximum C-IMT per 10 mg/dl in fasting plasma glucose. We also observed a graded association between fasting plasma glucose, postprandial glucose and HbA1c and the presence of carotid target organ damage (TOD), with an odds ratio of 1.013, 1.010 and 1.425, respectively.

Conclusion: The results of this study suggest that the fasting plasma glucose and HbA1c, but not postprandial glucose, are associated with C-IMT media and maximum. The patients who present with a metabolic glucose alteration have more risk of developing carotid TOD.

Trial registration: ClinicalTrials.gov; Identifier: NCT01428934 .

Keywords: Fasting plasma glucose; Glycosylated hemoglobin; Intima-media thickness; Postprandial glucose.

Figures

Fig. 1
Fig. 1
Percentage of subjects depending on the test used in the diagnosis of normal glucose metabolism and prediabetes, FPG fasting plasma glucose. PG postprandial glucose. HbA1c glycosylated hemoglobin
Fig. 2
Fig. 2
ANOVA test results: Carotid intima media thickness by tertiles of fasting plasma glucose (mg/dl), postprandial glucose (mg/dl) and glycated hemoglobin (%)

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Source: PubMed

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