One-Hour Plasma Glucose Levels May Be a Marker for Cardiovascular Risk
By Laurie Barclay, MD
Medscape Medical News
December 10, 2009 — Elevated 1-hour plasma glucose (1hPG) levels in persons without overt diabetes (DM) may be a marker for cardiovascular risk, according to the results of a study reported online in the November 16 issue of Diabetes Care.
"[Pre-DM] identifies subjects with impaired fasting glucose...and/or impaired glucose tolerance (IGT) at high risk for type 2 diabetes (DM2); moreover, it is associated to insulin resistance..., subclinical inflammation and cardiovascular diseases (CVD)," write Gianluca Bardini, MD, PhD, from the University of Florence in Italy, and colleagues. "Recently, 1-hour hyperglycaemia (1hPG) during glucose tolerance test (OGTT) with a cut point of 155 mg/dl has been indicated as a further risk factor for DM2 and showed early carotid atherosclerosis."
The study goal was to evaluate metabolic characteristics and markers of inflammation in 1062 participants with normal glucose tolerance (NGT) and pre-DM. Fibrinogen and leukocytes count (WBC) for subclinical inflammation, lipid ratios, and insulin sensitivity measured with the Matsuda Index were compared in participants with or without 1hPG levels higher than 155 mg/dL after oral glucose loading.
Compared with participants with 1hPG levels of 155 mg/dL or lower, those with 1hPG levels higher than 155 mg/dL had significantly increased inflammatory markers and lipid ratios (P < .05 for all comparisons). An analysis adjusted for age, sex, and body mass index showed that 1hPG was associated with significantly increased WBC count and fibrinogen (P < .05). Compared with patients with 1hPG levels of 155 mg/dL or lower, those with 1hPG levels higher than 155 mg/dL had significantly lower insulin sensitivity (P < .01).
"Elevated 1hPG in NGT and pre-DM subjects is associated to subclinical inflammation, high lipid ratios and insulin resistance," the study authors write. "Therefore, 1hPG >155 mg/dl could be considered a new 'marker' for cardiovascular risk."
The study authors have disclosed no relevant financial relationships.
Diabetes Care. Published online November 16, 2009.
