Abstract
BackroundTo evaluate the importance of oral glucose tolerance test (OGTT) in predicting diabetes and cardiovascular disease in patients with and without Metabolic Syndrome from a population treated in a primary care unit.Research design and methodsA prospective cohort study was conducted with subjects regularly attending the primary care unit of Hospital de Clínicas de Porto Alegre. Participants underwent a 75 g OGTT. Metabolic syndrome definition was based on the criteria of IDF/AHA/NHLBI-2010.ResultsParticipants mean age was 61 ± 12 years (males: 38%; whites: 67%). Of the 148 subjects included, 127 (86%) were followed for 36 ± 14 months, 21 (14%) were lost. Subjects were classified into four groups based on baseline OGTT: 29% normal (n = 43), 28% impaired fasting glucose (IFG; n = 42), 26% impaired glucose tolerance (IGT; n = 38), and 17% diabetes (n = 25). Metabolic syndrome prevalence was lower in normal group (28%), intermediate in IFG (62%) and IGT (65%) groups, and higher among subjects with diabetes (92%; P <0.001). Incidence of diabetes increased along with the stages of glucose metabolism disturbance (normal: 0%, IFG: 16%, IGT: 28%; P = 0.004). No patient with normal OGTT developed diabetes, regardless metabolic syndrome presence. Diabetes at baseline was the major determinant of cardiovascular disease occurrence (normal: 0%, IFG: 4%, IGT: 0%, diabetes: 24%; P = 0.001). In Cox-regression analysis, only the 2 h OGTT results were associated with diabetes (OR = 1.03; 95%CI 1.01–1.06; P <0.001) and cardiovascular disease development (OR = 1.013; 95%CI 1.002–1.025; P = 0.024).ConclusionsIn this sample of subjects undergoing diabetes screening, the OGTT predicted diabetes and cardiovascular disease more effectively than the metabolic syndrome status.
Highlights
Hyperglycemia is a well-known risk factor for microand macrovascular disease [1] and is associated with increased morbidity and mortality [2,3]
Subjects were classified into four groups based on baseline oral glucose tolerance test (OGTT): 29% normal (n = 43), 28% impaired fasting glucose (IFG; n = 42), 26% impaired glucose tolerance (IGT; n = 38), and 17% diabetes (n = 25)
Incidence of diabetes increased along with the stages of glucose metabolism disturbance
Summary
Hyperglycemia is a well-known risk factor for microand macrovascular disease [1] and is associated with increased morbidity and mortality [2,3]. Patients with type 2 DM have a higher prevalence of MetS (85% vs 24% in general population) [16,17] and the aggregation of MetS components amplifies the risk for micro- and macrovascular complications [17]. Because both prediabetes and MetS are risk factors for DM and cardiovascular disease (CVD), it is likely that the two conditions coexist in the same individuals.
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