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Differences in Cardiovascular Risk Factors, Insulin Resistance, and Insulin Secretion in Individuals With Normal Glucose Tolerance and in Subjects With Impaired Glucose Regulation

The Telde Study

¹ Endocrinology and Nutrition Section, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
² Mathematics Department, University of Las Palmas, Las Palmas de Gran Canaria, Spain
³ Hematology Service, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
⁴ Hospital General de Fuerteventura, Puerto del Rosario, Las Palmas, Spain

Address correspondence and reprint requests to Francisco J. Nóvoa, Endocrinology and Nutrition Section, Hospital Universitario Insular, Las Palmas de Gran Canaria 35016, Spain. E-mail: fnovoa{at}dcmq.ulpgc.es

OBJECTIVE—To assess the cardiovascular risk profile, the degree of insulin resistance, and ß-cell secretion in a cohort of subjects with different categories of impaired glucose regulation (IGR): impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and combined IFG/IGT.

RESEARCH DESIGN AND METHODS—We studied 902 nondiabetic subjects between 30 and 80 years of age, recruited from a cross-sectional population-based study in Telde, Gran Canaria Island, Spain. Categories of glucose tolerance were defined according to 2003 modified American Diabetes Association criteria. Risk factors for cardiovascular disease, the presence of the metabolic syndrome, and indirect measures of both insulin resistance and ß-cell function were analyzed.

RESULTS—A total of 132 (14.6%) participants had isolated IFG, 59 (6.5%) isolated IGT, and 48 (5.3%) combined IFG/IGT. Groups with normal glucose tolerance (NGT) and combined IFG/IGT had, respectively, the most favorable and unfavorable levels of cardiovascular risk factors, metabolic syndrome rates, and measures of insulin resistance. Subjects with IFG and IGT showed an intermediate profile between NGT and IFG/IGT categories. We found no significant differences between IFG and IGT in cardiovascular risk factors, metabolic syndrome prevalence, or insulin resistance. The IFG group exhibited a more impaired insulin secretion than those with IGT or IFG/IGT.

CONCLUSIONS—Individuals with IGR, especially those with IFG/IGT, have increased values of cardiovascular risk factors and higher indexes of insulin resistance. Groups with isolated IFG and isolated IGT present similar cardiovascular risk profiles. Subjects with IFG are characterized by more defective ß-cell function than other forms of IGR.

Abbreviations: ADA, American Diabetes Association • CVD, cardiovascular disease • FPG, fasting plasma glucose • HOMA-IR, homeostasis model assessment for insulin resistance • IFG, impaired fasting glucose • IGR, impaired glucose regulation • IGT, impaired glucose tolerance • NGT, normal glucose tolerance • OGTT, oral glucose tolerance test • PAI-1, plasminogen activator inhibitor-1 • QUICKI, quantitative insulin-sensitivity check index

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