Prediabetes linked to incident cardiovascular disease
Sophie V. Eastwood, M.B., B.Ch., from University College London, and colleagues examined longitudinal associations between prediabetes and CVD (coronary heart disease [CHD] and stroke) in a U.K. cohort of 1,336 Europeans and 1,139 South Asians. At 20 years from baseline (1988 to 1991), the authors examined incident CHD and stroke by death certification, hospital admission, primary care record review, and participant report.
The researchers found that International Expert Committee (IEC)-defined prediabetes correlated with both CHD and CVD risk in Europeans but not South Asians (ethnicity interaction P = 0.008 and 0.04, respectively), compared with normoglycemic individuals. In contrast, IEC-defined prediabetes correlated with stroke risk in South Asians, but not Europeans (ethnicity interaction P = 0.11). Risks were adjusted for potentially confounding variables. With oral glucose tolerance test or American Diabetes Association-defined prediabetes the correlations were weaker. South Asians had greater time from conversion of prediabetes to diabetes, but this difference did not account for the ethnic differences.
"Associations between prediabetes and CVD differed by prediabetes diagnostic criterion, type of CVD, and ethnicity, with associations being present for overall CVD in Europeans but not South Asians," the authors write. "Substantiation of these findings and investigation of potential explanations are required."
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