Effect Of Prediabetes Research Articles

Prediabetes and major adverse cardiac events after acute coronary syndrome: An overestimated concept.

Unlike diabetes, the effect of prediabetes on outcomes in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) is not much investigated. We investigated the association between fasting glycemic status and major adverse cardiovascular and cerebrovascular events (MACCE) in patients with ACS undergoing PCI and had mid to long-term follow-up after coronary stenting. Registry-based retrospective cohort study included ACS patients who underwent PCI at the Tehran Heart Center from 2015 to 2021 with a median follow-up of 378 days. Patients were allocated into normoglycemic, prediabetic, and diabetic groups. The primary and secondary outcomes were MACCE and its components, respectively. Unadjusted and adjusted Cox models were used to evaluate the association between glycemic status and outcomes. Among 13 682 patients, 3151 (23%) were prediabetic, and 5834 (42.6%) were diabetic. MACCE risk was significantly higher for diabetic versus normoglycemic (adjusted hazard ratio [aHR]: 1.22, 95% confidence interval [CI]: 1.06-1.41), but nonsignificantly higher for prediabetic versus normoglycemic (aHR: 0.95, 95% CI: 0.78-1.10). All-cause mortality risk was significantly higher in diabetic versus normoglycemic (aHR: 1.42, 95% CI: 1.08-1.86), but nonsignificantly higher for prediabetic versus normoglycemic (aHR: 1.15, 95% CI: 0.84-1.59). Among other components of MACCE, only coronary artery bypass grafting was significantly higher in diabetic patients, and not prediabetic, compared with normoglycemic. Prediabetic ACS patients undergoing PCI, unlike diabetics, are not at increased risk of MACCE and all-cause mortality. While prediabetic patients could be regarded as having the same risk as nondiabetics, careful consideration to provide more intensive pre- and post-PCI care in diabetic patients is mandatory.

The effect of prediabetes and diabetes on the incidence of cardiovascular disease in the population of 40 to 70 years in the south of Iran: a population-based cohort study

The effect of prediabetes and diabetes on the incidence of cardiovascular disease in the population of 40 to 70 years in the south of Iran: a population-based cohort study

The association between prediabetes and bone mineral density: A meta-analysis.

Prediabetes is an intermediate metabolic state between euglycaemia and diabetes, including three different definitions: impaired fasting glucose, impaired glucose tolerance, and mildly elevated glycated haemoglobin (HbA1c) (range 5.7%-6.4%). The effect of prediabetes on bone mineral density (BMD) has not been established. Therefore, we performed a meta-analysis to evaluate the association between prediabetes and BMD. We retrieved studies related to prediabetes and BMD from PubMed, Web of Science, and Embase databases from January 1990 to December 2022. All data were analysed using the random effects model. Statistical heterogeneity was tested by I2 . Subgroup analysis was performed after each study-level variable was pre-defined by meta-regression. A total of 17 studies were included involving 45,788 patients. We detected a significant overall association of prediabetes with increased spine BMD (weighted mean difference [WMD]=0.01, 95% CI [0.00, 0.02], p=0.005; I2 =62%), femur neck (FN) BMD (WMD=0.01, 95% CI [0.00, 0.01], p<0.001; I2 =19%), and femur total (FT) BMD (WMD=0.02, 95% CI [0.01, 0.03], p<0.001; I2 =51%). Several variables leading to heterogeneity were defined by meta-regression, including age, sex, region, study type, dual-energy X-ray absorptiometry scanner manufacturer, and prediabetes definition. Subgroup analyses indicated that the association of prediabetes with increased BMD was stronger in men, Asians, and older adults over 60years of age. Current evidence shows that prediabetes is strongly associated with increased BMD of the spine, FN, and FT. The association was stronger among males, Asians, and older adults over 60years of age.

The bidirectional relationship between NAFLD and type 2 diabetes: A prospective population-based cohort study

Background and aimsTo explore the bidirectional relationship between NAFLD and type 2 diabetes and the possible directions of the main effect. Methods and results30 633 participants from the Jinchang cohort were enrolled. Firstly, cox proportional hazards regression model was used to assess the unidirectional causality between NAFLD and prediabetes and type 2 diabetes. Secondly, cross-lag path analysis model was conducted to estimate the bidirectional relationship between NAFLD and prediabetes and type 2 diabetes, and to determine the direction of the main effects. Finally, potential effect modifications were also considered by age, sex, hyperlipidemia, and overweight/obesity. We found that NAFLD increased the risk of prediabetes and type 2 diabetes with adjusted HR (95%CI) of 1.355(95%CI: 1.255–1.462) and 1.898(95%CI: 1.415–2.545), respectively. Prediabetes and type 2 diabetes also increased the risk of NAFLD, with adjusted HR (95%CI) of 1.245(95%CI: 1.115–1.392) and 1.592(95%CI: 1.373–1.846), respectively. Cross-lag path analysis showed that NAFLD significantly affected the incidence of prediabetes (β = 0.285, P < 0.001), while the effect on type 2 diabetes was not statistically significant. The effect of prediabetes and type 2 diabetes on the risk of NAFLD was weak, and the path coefficients were 0.076 and 0.037, respectively. Stratified analyses showed similar results. ConclusionThis study provides evidence that there was a bidirectional causal association between NAFLD and type 2 diabetes, and the progression from NAFLD through prediabetes to type 2 diabetes may be the main pathway.

Effect of Prediabetes on Long-Term Risk of Developing Cardiac Events in Patients Presenting With Acute Coronary Syndrome

Type 2 diabetes is associated with an increased risk of recurrent coronary events compared to individuals without diabetes. However, whether prediabetes confers a similar risk to established diabetes for developing subsequent cardiac events is less clear. This study aims to investigate the long-term risk associated with prediabetes and developing subsequent cardiac events in patients presenting with acute coronary syndrome (ACS) at the University of Ottawa Heart Institute.

Left ventricular myocardial performance index in prediabetic patients without coronary artery disease

BackgroundPrediabetes is considered a major risk factor for diabetes mellitus (DM), leading to microvascular and cardiovascular disorders. Myocardial performance index (MPI) is a non-invasive Doppler method for the determination of global ventricular activity. We have not enough knowledge about the effect of prediabetes on the left ventricular (LV) function. We aimed to assess the MPI in prediabetic patients without coronary artery disease (CAD) utilizing echocardiography tissue Doppler imaging (TDI).ResultsWe conducted a randomized controlled study that included fifty prediabetic patients and fifty healthy participants as the control group. All the participants were subjected to laboratory tests and echocardiography TDI to evaluate the LV systolic and diastolic functionsWe found that the isovolumic relaxation time (IVRT) and MPI values were significantly increased in the prediabetic patients compared to the control group (P < 0.001). In contrast, left ventricular ejection time (ET) was significantly longer in the control group than in prediabetic patients.ConclusionPrediabetes may adversely affect the LV function as assessed by MPI. Screening for prediabetes and early intervention is required for the prevention of cardiovascular morbidity and mortality.

Effect of prediabetes on asprin or clopidogrel resistance in patients with recent ischemic stroke/TIA.

Diabetes mellitus (DM) had been discovered as an independent risk factor for high on-treatment platelet reactivity (HPR) in patients with ischemic stroke. However, studies on the relationship between prediabetes and the occurrence of HPR remain scarce. This study is aimed at clarifying the association between prediabetes and HPR among patients with recent ischemic stroke or transient ischemic stroke (TIA). Patients with ischemic stroke or TIA within 90days after onset were recruited consecutively. All patients were divided into three groups: DM, prediabetes, and normal glucose tolerance according to fasting glucose, HbA1c, or OGTT. Three months later, all patients were performed platelet aggregation inhibition test and screened for high on-treatment platelet reactivity. The effect of prediabetes on HPR was analyzed in a multivariable logistic regression model. This study recruited 237 patients with ischemic stroke or TIA, including 57 cases with prediabetes, 108 with DM, and 72 with normal glucose tolerance. Aspirin and/or clopidogrel resistance was discovered in 28 cases among prediabetes group, which was significantly more frequent than normal glucose tolerance group(49.1% versus 33.3%, P = 0.046). After adjusting for confounding factors, prediabetes was found as an independent risk factor for high on-treatment platelet reactivity (HPR) among patients with recent ischemic stroke or TIA (odds ratio 2.92; 95% CI, 1.29 to 6.63, P = 0.01). Prediabetes was an independent risk factor for high on-treatment platelet reactivity in patients with recent ischemic cerebrovascular disease. Patients with prediabetes should be highlighted for the efficacy test of antiplatelet drugs.

Effect of prediabetes on the long-term all-cause mortality of patients undergoing percutaneous coronary intervention: A protocol for systematic review and meta analysis.

Background:Prediabetes is an abnormal metabolic state that develops prior to the onset of diabetes with proven to common comorbid states of coronary artery disease. However, whether prediabetes worsens prognosis after percutaneous coronary intervention remains controversial. The aim of this study is to summarize previous cohort studies and to specify the impact of prediabetes on the long-term outcomes after percutaneous coronary intervention.Methods:This meta-analysis will be performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines for conducting and reporting meta-analysis data. Pubmed, Embase and Google scholar will be systematically searched, and supplemented with manual searches of the included reference lists to identify cohort studies. Pooled effects on the discontinuous variables will be expressed by adjusted hazard ratios with 95% confidence intervals. All analyses will be performed with Stata 15.0 (StataCorp LP, College Station, TX).Results:The results of this study will be published in a peer-reviewed journal.Conclusion:This systematic review will provide new information and help enhance clinical decision-making on management of these patients.Registration number:INPLASY202060079.

1478-P: Having Prediabetes before the Detection of Tuberculosis: Does It Have a Negative Influence on Treatment?

Aim: Coexistence of DM and TB influences TB treatment outcomes. TB increases hyperglycaemia due to inflammatory response. Effect of prediabetes (PDM) on TB treatment outcomes is unknown. The aim was to assess the effect of PDM on treatment outcomes after TB treatment. Methods: This is a prospective observational cohort study (EDOTS - part of RePORT India Consortium) of 569 eligible New smear positive cases screened for DM between 2014 to 2018 in TB units in North Chennai, South India. Out of 569 subjects, 179 with a known history of DM were excluded.The remaining 390 screened TB subjects, 120 were excluded based on culture results and unwillingness to participate in the study. HbA1c was assessed at baseline and categorised into two groups (Gp): normoglycaemia (Gp1) (&amp;lt;5.7%) and PDM (Gp 2) (5.7 to 6.4%) and followed them at 3rd and 6th month and treatment outcomes were assessed at the end of the TB treatment. Results: Prevalence of Prediabetes was 41.1%. There was no significant difference in the treatment outcomes between the groups(p=0.54). Total cure rate was 72.7% with no significant difference between the groups. There was a higher proportion of treatment failures (7.9%) amongGp1 as compared to Gp 2 (4.5%) (p = 0.33). There were 15.8 vs. 17.1% treatment defaulters. Higher proportion of deaths occurred during the course of DOTS in Gp 2 (7.2%) compared to Gp 1 (1.3%) (p = 0.06). At the end of intensive phase of DOTS treatment, about 23.8 % were observed to have positive sputum smear in Gp 2 compared to 8.6% in Gp 1 (p=0.019). The estimated relative risk to remain as sputum smear positive among prediabetes at the end of intensive phase was 3.0 (95% CI: 1.2-7.6). Conclusion: Higher prevalence of prediabetes was evident among TB patients. Among those who had prediabetes, death rate was higher during the course of the treatment and higher proportion remained sputum smear positive at the end of the intensive phase of TB treatment. Disclosure V. Viswanathan: None. A. Devarajan: None. S. Kumpatla: None. M. Dhanasekaran: None. S. Babu: None. H. Kornfeld: None. Funding Government of India (BT/MB/INDO-US/REPORT/03/2013-140)

Correlation between prediabetes and coronary artery disease severity in patients undergoing elective coronary angiography

BackgroundDiabetes is a chronic disease that is responsible for a high rate of morbidity and mortality which can be attributed to atherosclerosis and cardiovascular disease. Diabetes is heralded by prediabetes which not only indicates a higher risk of developing diabetes but also increases the burden of cardiovascular disease. The objective was to observe the effect of prediabetes on the severity of coronary artery disease in patients undergoing elective coronary angiography. Seven hundred and thirty-one patients were admitted for elective coronary angiography and/or PCI starting from September 2017 to August 2018. Patients were divided into group A (normoglycemic group, N = 228), group B (prediabetes group, N = 177), and group C (diabetic group, N = 326). Coronary artery disease (CAD) severity including number of vessels affected and atherosclerotic burden by Gensini score were compared among different groups.ResultsThe number of vessels affected as well as left main (LM) disease was higher in the prediabetes group when compared to the normoglycemic group (P,=0.001, P = 0.009, respectively) and was comparable to the diabetes group (P = 0.4, P = 0.6, respectively). Prediabetes showed a Gensini score higher than the normoglycemic group (P = 0.0001) with no significant difference when compared to the diabetic group (P = 0.9).ConclusionPrediabetes is associated with high atherosclerotic burden and coronary artery disease complexity that is similar to diabetic than normoglycemic individuals.

The effect of prediabetes on hepatocellular carcinoma risk: a systematic review and meta-analysis.

Some studies suggested an increased risk of hepatocellular carcinoma (HCC) risk in subjects with prediabetes, whereas other studies have reported negative results. Therefore, we did this meta-analysis to assess the role of prediabetes on HCC risk. We searched studies from PubMed, Embase, and Web of Science databases. The strength of association between prediabetes and HCC risk was assessed by calculating hazard ratio (HR) with 95% CI. A total of 8 cohort studies and 1 case-control study with 1384594 individuals were included. Patients with prediabetes showed an increased HCC risk (HR=1.21; 95% CI, 1.13-1.30; P<0.00001). Subgroup analyses were performed according to race and gender. The results showed that both Asians with prediabetes (HR=1.19; 95% CI, 1.11-1.28; P<0.00001) and Caucasians with prediabetes (HR=2.12; 95% CI, 1.36-3.31; P=0.001 were significantly associated with increased risk of HCC, respectively. In the subgroup analysis by gender, both male patients with prediabetes (HR=1.49; 95% CI, 1.03-2.15; P=0.03) and female patients with prediabetes (HR=1.24; 95% CI, 1.01-1.52; P=0.04) showed increased risk of HCC, respectively. In conclusion, this meta-analysis demonstrated that prediabetes might be a risk factor of HCC.

Outcomes in the offspring of mothers with pre-diabetes during pregnancy: a protocol for a systematic review

BackgroundDespite the increasing prevalence of pre-diabetes worldwide, there is insufficient literature on the impact of gestational pre-diabetes on offspring outcomes. The objective of this systematic review is to determine the risk of developing adverse outcomes for the offspring in women with pre-diabetes compared to women with normal glucose levels and women with gestational diabetes mellitus.Methods/designA systematic search of the published literature will be conducted for experimental and observational studies that report outcomes in the offspring of mothers with pre-diabetes during pregnancy. Databases including EMBASE, PsycINFO, and PubMed will be searched from 1979 (the year when the terms impaired glucose tolerance and pre-diabetes were coined) to December 2014. Screening of identified articles and data extraction will be conducted in duplicate and independently. Methodological quality of the included studies will be assessed using the Newcastle-Ottawa scale. Discrepancies will be resolved by consensus or by consulting a third author. Meta-analyses will be performed, and findings will be reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and the meta-analysis of observational studies in epidemiology (MOOSE) guidelines.DiscussionDetermining the effect of pre-diabetes on offspring outcome will be important for clinicians providing care to pregnant women and their offspring. This review will also identify any gaps in the current literature on this topic and provide direction for future research in this area of study.Systematic review registrationPROSPERO CRD42015015536

Sex-specific differences in progressive glucose intolerance and hip geometry: the Baltimore Longitudinal Study of Aging.

Fracture risk is increased in type 2 diabetes mellitus (T2DM). The effect of pre-diabetes and T2DM on bone macroarchitecture and strength has not been well investigated. In this study, we show that in women only, both pre-diabetes and T2DM are associated with decreased hip bending strength and mineralization which might lead to skeletal weakness. Older men and women with T2DM are at increased risk for fracture despite normal bone mineral density (BMD). The discordance between bone quantity and skeletal fragility has driven investigation into additional determinants of fracture resistance in T2DM. Additionally, the effect of pre-diabetes on bone strength has not been well described. The aim of this study was to determine differences in bone macroarchitecture and strength, measured by hip geometry, in persons with normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and T2DM. We performed cross-sectional analyses of older (age >55years) men (n = 472) and women (n = 473) participating in the Baltimore Longitudinal Study of Aging (BLSA) classified as NGT, IGT, or T2DM based on oral glucose tolerance testing. Bone strength measures included the hip geometry parameters of section modulus (Z), cross-sectional area (CSA), and buckling ratio (BR). Sex-stratified analyses were conducted using adjusted stepwise regression models. In women, IGT and T2DM were negatively associated with hip geometry parameters including mineralization in cross section (CSA, ß -0.076 and -0.073, respectively; both p < 0.05) and hip bending strength (Z, ß -0.097 and -0.09, respectively; both p < 0.05); conversely, IGT and T2DM were associated with improved compressive strength (BR, ß -0.31 and -0.29, respectively; both p < 0.05). There was no significant association between glycemic status and hip geometry in men. In women only, both IGT and T2DM were inversely associated with bone macroarchitecture and measures of bone mineralization and bending strength. The same association between worsening glycemic status and bone strength was not observed in men. These data suggest a differential effect of sex on hip geometry with evolving glucose intolerance.

Effect of pre-diabetes on future risk of stroke: meta-analysis

Objectives To assess the association between pre-diabetes and risk of stroke, and to evaluate whether this relation varies by diagnostic criteria for pre-diabetes.Design Systematic review and meta-analysis of prospective studies.Data...

Bone Mineral Density in Prediabetic Men

BackgroundThere are many studies regarding the effects of insulin on bone metabolism and changes in bone mineral density (BMD) in the setting of diabetes. The effect of prediabetes on BMD is not known.MethodsA total of 802 men participated in the Korea Rural Genomic Cohort Study (in Geumsan County). According to the results of an oral glucose tolerance test, subjects were classified into normal, prediabetic, and diabetic categories. One hundred twenty-four subjects diagnosed with type 2 diabetes were excluded, leaving 678 subjects for the study inclusion. BMD was estimated with a quantitative ultrasonometer.ResultsThe average BMD T scores of normal and prediabetic subjects were -1.34 ± 1.42 and -1.33 ± 1.30, respectively; there was no significant difference in the BMD T scores between these groups. The BMD T score was inversely associated with age and positively correlated with body weight, body mass index, total cholesterol, low density lipoprotein cholesterol, and HbA1c. On multiple linear regression analysis, low density lipoprotein cholesterol was the only statistically significant variable for prediabetes (β = 0.007, P = 0.005). On the stepwise regression analysis, age (β = -0.026, P < 0.001), the body mass index (β = 0.079, P < 0.001), and low density lipoprotein cholesterol (β = 0.004, P = 0.016) were significant variables for prediabetes.ConclusionsThere was no significant difference in the BMD T score between the normal and prediabetic subjects. Further studies are needed regarding the association of fracture risk and changes in BMD with the development of overt diabetes.