PS-C05-10: INDIVIDUALS WITH PRE-IMPAIRED GLUCOSE TOLERANCE (PRE-IGT) HAVE ALREADY ENDOTHELIAL DYSFUNCTION BUT WITH NO SIGNIFICANT IDENTIFIABLE CARDIOVASCULAR RISK FACTORS

Abstract

Objective: Pre-impaired glucose tolerance (pre-IGT), characterized as normoglycemia with hyperinsulinemia, is the earliest stage of dysmetabolism in type 2 diabetes mellitus (DM). C-peptide, which is equimolar to insulin, has been shown to cause intima-media thickening when present in increased amounts. This study aims to determine the prevalence of endothelial dysfunction among individuals with pre-IGT and to determine the cardiovascular risk factors for developing endothelial dysfunction. Design and method: We employed a cross-sectional analytical study of adult patients with risk factors for developing diabetes [first-degree relative with type 2 DM, obesity, history of gestational diabetes (GDM), and polycystic ovary syndrome (PCOS)]. Brachial artery flow-mediated dilatation (FMD) was performed on pre-IGT patients to test for the presence of endothelial dysfunction. Cardiovascular risk factors evaluated were age, 2-hr insulin and glucose level after 75 gms OGTT, BMI, lipids, and systolic and diastolic blood pressure. Binary logistic regression was used to determine the significant risk factors affecting endothelial dysfunction, Results: Of the 67 subjects, 41 had pre-IGT with a prevalence of 61%. Among the pre-IGT who had FMD studies (31/41), seven had FMD (+) with a prevalence of 22.58%. Although statistically not significant, FMD (+) vs. FMD (-) subjects were respectively, older (mean 28.86 (SD 4.34) vs. 25.96 years (SD 25.96), p = 0.112), more obese (mean (SD) 26.87 (4.36) vs. 25.18 kg/m2 (4.83), p = 0.257), had higher 2nd hr glucose and HbA1c (mean (SD) 2-hr glucose; 106.34 (13.36) vs. 105 mg/dL (17.55), p = 0.620, mean (SD) HbA1c; 5.30 (0.37) vs. 5.23% (0.37), p = 0.669), and higher total cholesterol and LDL (mean (SD) cholesterol; 182.13 (21.51) vs.177.07 mg/dL (20.70), p = 0.620, mean (SD) LDL; 105.68 (3.77) vs. 98.58 mg/dL (19.25), p = 0.357). Conversely, FMD (+) vs. FMD (-) subjects had respectively, lower values of the following; 2nd hour insulin levels (mean (SD) 101.32 (76.10) vs. 122.44 uIU/mL (101.83), p = 0.450), mean (SD) systolic BP (109.71 (11.40) vs.110.67 mmHg (13.10), p = 0.886), and mean (SD) diastolic BP (71 (9.11) vs. 74.13 mmHg (10.60), p = 0.683). Similarly, the difference was not statistically significant. Comparative analyses also yielded no significant difference in the demographics (family history, GDM, PCOS) of the two groups. Conclusion: Endothelial dysfunction is already present among individuals with pre-IGT. The study did not demonstrate any significant difference in the previously reported cardiovascular risk factors contributing to endothelial function abnormality.