Abstract
Prediabetes is the precursor stage of diabetes mellitus and is also considered to be a risk factor for the development of cardiovascular disease. Atherogenic indices have been used for assessment of risk for cardiovascular disease development. To date, there is no data on evaluating the relationship between atherogenic indices (cardiac risk ratio (CRR), atherogenic coefficient (AC), and atherogenic index of plasma (AIP)) and carotid intima-media thickness (CIMT) in prediabetes. Hence, we aimed to determine atherogenic indices (CRR, AC, and AIP) and CIMT in prediabetic subjects and then sought to evaluate the relationship between them. A total of 400 human subjects were included in the present study, out of which 200 were prediabetic subjects and 200 were normal healthy control subjects. For each subject, CRR, AC, and AIP were calculated from routine lipid parameters and carotid intima-media thickness was measured as well. Atherogenic indices, that is, CRR, AC, and AIP, were significantly increased in prediabetic subjects as compared to the controls (5.87 ± 0.87 vs. 4.23 ± 0.50, p < 0.001; 4.87 ± 0.87 vs. 3.23 ± 0.50, p < 0.001; and 0.29 ± 0.07 vs. 0.09 ± 0.09, p < 0.001, respectively). Moreover, a significant and positive correlation was observed between CIMT and AIP (r = 0.529, p < 0.01), CRR (r = 0.495, p < 0.01), and AC (r = 0.495, p < 0.01). Prediabetic subjects present abnormalities in atherogenic indices and CIMT, which indicate a greater propensity of prediabetes for the development of cardiovascular disease. Hence, atherogenic indices can be used in addition to routine lipid parameters for the better assessment of subclinical atherosclerosis in prediabetic subjects.
Highlights
Prevalence of diabetes, which is associated with an increase in morbidity and mortality, is increasing and it is one of the major healthcare problems in the world [1]
The participants were selected from the general population, and those who were at risk of developing diabetes (who had at least one of the main risk factors for diabetes: first degree relative with diabetes, body mass index (BMI) ≥ 25 kg/m2, women who were diagnosed with gestational diabetes mellitus, women with polycystic ovary syndrome, persons who are physically inactive, and other clinical conditions associated with insulin resistance, for example, severe obesity, acanthosis nigricans, etc.) during the period of March 2017 to May 2018 in Gwalior City were identified through a predesigned screening questionnaire
Subjects with prediabetes had a significantly increased mean BMI, Waist circumference (WC), Hip circumference (HC), and Waist-to-hip ratio (WHR) compared with the control subjects, indicating that prediabetic subjects had a higher rate of general obesity and central obesity
Summary
Prevalence of diabetes, which is associated with an increase in morbidity and mortality, is increasing and it is one of the major healthcare problems in the world [1]. According to the pathogenesis and natural history of diabetes, it has a prolonged prediabetic phase, which is considered to be a high-risk state for diabetes [2] and can be defined by glycemic levels that are higher than normal but below the diagnostic parameters required for a diagnosis of diabetes [3]. The prevalence of prediabetes is increasing globally. In the year 2015, the International Diabetes Federation estimated that the worldwide prevalence of prediabetes was 318 million and is predicted to reach 482 million by the year 2040 [4]. In India, the prevalence of prediabetes was reported to be 10.3% in the year 2017 [5].
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