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Cardiometabolic Risk in Impaired Fasting Glucose and Impaired Glucose Tolerance

The Atherosclerosis Risk in Communities Study

¹ Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
² Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
³ Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
⁴ Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
⁵ Departments of Medicine and Epidemiology, Johns Hopkins University, Baltimore, Maryland
⁶ Department of Medicine, Baylor College of Medicine, Houston, Texas

Address correspondence and reprint requests to James S. Pankow, Division of EpidemiologyCommunity Health, University of Minnesota, 1300 South Second St., Suite 300, Minneapolis, MN 55454. E-mail: pankow{at}epi.umn.edu

OBJECTIVE—We compared and contrasted cardiovascular disease (CVD) risk factors, subclinical manifestations of CVD, incident coronary heart disease (CHD), and all-cause mortality by categories of impaired glucose regulation in nondiabetic individuals.

RESEARCH DESIGN AND METHODS—The study included 6,888 participants aged 52–75 years who had no history of diabetes or CVD. All-cause mortality and incident CHD were ascertained over a median of 6.3 years of follow-up.

RESULTS—Agreement between fasting and postchallenge glucose impairment was poor: 3,048 subjects (44%) had neither impaired fasting glucose (IFG) nor impaired glucose tolerance (IGT), 1,690 (25%) had isolated IFG, 1,000 (14%) had isolated IGT, and 1,149 (17%) had both IFG and IGT. After adjustment for age, sex, race, and center, subjects with isolated IFG were more likely to smoke, consume alcohol, and had higher mean BMI, waist circumference, LDL cholesterol, and fasting insulin and lower HDL cholesterol than those with isolated IGT, while subjects with isolated IGT had higher mean triglycerides, systolic blood pressure, and white cell counts. Measures of subclinical CVD and rates of all-cause mortality and incident CHD were similar in isolated IFG and isolated IGT.

CONCLUSIONS—Neither isolated IFG nor isolated IGT was associated with a more adverse CVD risk profile.

Abbreviations: ADA, American Diabetes Association • ARIC, Atherosclerosis Risk in Communities • CHD, coronary heart disease • CVD, cardiovascular disease • IFG, impaired fasting glucose • IGT, impaired glucose tolerance • IMT, intima-media thickness • OGTT, oral glucose tolerance test

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