The association between elevated fasting plasma glucose levels and carotid intima-media thickness in non-diabetic adults: a population-based cross-sectional study

Yalin Guan,Changshen Yu,Jun Tu,Lingling Bai,Jinghua Wang,Yanan Wu,Min Shi,Hongfei Gu,Xianjia Ning,Jie Liu,Jingxian Ni

doi:10.18632/oncotarget.22302

Abstract

We assessed the association between the mean carotid intima-media thickness (CIMT) and fasting plasma glucose (FPG) levels in a low-income population in rural China. Adults aged ≥45 years without a history of diabetes, stroke, or cardiovascular disease were recruited. All participants were categorized into four groups according to FPG level. A total of 3509 participants were analyzed in this study. In the univariate analysis, sex, age, education level, hypertension, central obesity, current smoking, alcohol consumption, and higher levels of FPG, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were associated with mean CIMT and frequency of increased CIMT. FPG levels were significantly associated with mean CIMT; each 1-mmol/L increase in FPG resulted in a 2.75-μm increase in mean CIMT when adjusted by age, sex, education level, current smoking status, alcohol consumption, hypertension, and the levels of TC, TG, HDL-C, and LDL-C (P = 0.044). However, the association between FPG and the frequency of increased CIMT disappeared after adjusting by covariates. These findings indicate that FPG is an independent determinant of mean CIMT in a non-diabetic population. Management and control of FPG levels is crucial for preventing atherosclerosis in populations with high stroke risks in China.

Highlights

Carotid artery atherosclerosis is associated with a high risk of cardiovascular disease (CVD) and stroke [1,2,3,4]
fasting plasma glucose (FPG) levels were significantly associated with mean carotid intima-media thickness (CIMT); each 1-mmol/L increase in FPG resulted in a 2.75-μm increase in mean CIMT when adjusted by age, sex, education level, current smoking status, alcohol consumption, hypertension, and the levels of total cholesterol (TC), TG, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) (P = 0.044)
These findings indicate that FPG is an independent determinant of mean CIMT in a non-diabetic population

Summary

Introduction

Carotid artery atherosclerosis is associated with a high risk of cardiovascular disease (CVD) and stroke [1,2,3,4]. The carotid intima-media thickness (CIMT) is determined using ultrasonography and is a noninvasive marker of early atherosclerotic disease [5,6,7] that has been proven in epidemiological and clinical studies to be a useful predictor of cardiovascular events [8,9,10,11]. Traditional cardiovascular risk factors have been shown to be determinants of CIMT in the general population [7]. As reported in our previous study, there was a dramatically increased incidence of first-ever stroke among a low-income Chinese population in rural China from 1992 to 2012, with an annual percentage change of 6.5% [14]. The prevalence of conventional risk factors has significantly increased in this population over the past several decades [15, 16]

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Conclusion