Impaired fasting glucose does not identify those at increased risk of atherosclerosis. A group of researchers led by Dr De Michele from Federico II University in Naples, Italy, studied whether diabetes, as defined by the new American Diabetes Association criteria, is linked to early signs of carotid atherosclerosis. The group measured cardiovascular risk factors and intima-media thickness of common carotid arteries and carotid bifurcations in 310 clinically healthy women aged 30 to 69 years.
The researchers showed that 17 women had newly diagnosed diabetes, 7 had fasting glucose levels >7.0mmol/L, 38 had impaired fasting glucose, and 248 had normal fasting glucose levels. Women with diabetes had a worse cardiovascular risk profile, with higher levels of triglycerides, body mass index, and diastolic blood pressure than women with impaired or normal fasting glucose levels. As glucose homeostasis worsened, the frequency of atherosclerotic plaques (intima-media thickness >1.2mm) increased. Only diabetes was associated with a significantly increased risk of carotid atherosclerosis, according to multivariate logistic regression analyses (odds ratio 11.5, 95% CI 1.4-92.7). The authors suggest that diabetes, defined according to the new American Diabetes Association criteria, is associated with early carotid atherosclerosis, and that impaired fasting glucose does not identify those at increased risk of atherosclerosis.