Verminderde glucosetolerantie is risicofaktor atherosclerose

Nieuws - 12 okt. 2010

Impaired glucose tolerance is atherosclerosis risk factor

12 October 2010

Impaired glucose tolerance, but not impaired fasting glucose, is a risk factor for early-stage atherosclerosis, results of a study demonstrate.

Impaired glucose tolerance and impaired fasting glucose are two established risk factors for the development of diabetes mellitus, Suichi Okada (Gunma University Graduate School of Medicine, Japan) and colleagues note in the journal Diabetic Medicine.

They add: "Similar to diabetes mellitus, impaired glucose tolerance is also associated with an increase in cardiovascular-related mortality, as well as mortality in general.

"However, the relationship between impaired fasting glucose and atherosclerosis is less clear."

To address this question, the researchers used brachial-ankle pulse wave velocity (baPWV) as a marker for arterial stiffness and vascular damage in 2842 patients from Takasaki city in Japan who were undergoing routine medical check-ups.

"The technical simplicity and short sampling time of the method used to measure baPWV make the method more feasible for screening a large population than conventional methods, such as the applanation tonometric method applied to the carotid and femoral arteries," Okada et al comment.

Patients were divided into the following five groups based on a 75-g oral glucose tolerance test: (i) normal fasting plasma glucose/normal glucose tolerance group, (ii) impaired fasting glucose group, (iii) impaired glucose tolerance group, (iv) combined glucose intolerance/fasting group, and (v) diabetic glucose intolerance group.

The researchers found that individuals with impaired glucose tolerance, combined impaired glucose fasting/tolerance, and diabetic glucose intolerance showed significantly higher baPWV values compared with the group with normal glucose parameters, at 1429 cm/s, 1491 cm/s, and 1534 cm/s versus 1300 cm/s, respectively.

Although the group with impaired fasting glucose had slightly increased baPWV values, the difference compared with the group with normal glucose parameters was not significant.

In multiple regression analyses, impaired glucose tolerance emerged as an independent predictor of baPWV, whereas no direct independent association was observed with fasting plasma glucose.

"Thus impaired glucose tolerance, but not impaired fasting glucose, is a risk factor for early-stage atherosclerosis… which is consistent with the data of earlier studies on the effect of post-prandial dysregulated metabolism on vascular damage," Okada et al comment.

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