Impaired Fasting Glucose Does Not Boost Cardiovascular Risk

Impaired fasting glucose doesn’t independently increase the risk of cardiovascular events in adults, according to a large new study.…

Dr. Joseph Yeboah from the University of Virginia School of Medicine, Charlottesville, wrote, “There are conflicting data on this association in highly selected cohorts. What is surprising is the fact that despite this conflicting data, the American Diabetes Association has stated that prediabetes is a cardiovascular risk factor.”  

Dr. Yeboah and colleagues used data from the Multi-Ethnic Study of Atherosclerosis (MESA) to investigate the associations of impaired fasting glucose (IFG) with type 2 diabetes and cardiovascular events in an ethnically diverse population of 6753 adults from six U.S. communities.

Compared with normal fasting glucose, IFG was associated with an insignificant increase in incident cardiovascular events (p=0.3). There was no association with incident cardiovascular events in any sex or race/ethnicity group, the authors reported in the July 5th Journal of the American College of Cardiology.

IFG was, however, associated with a 10.5-fold increased risk of type 2 diabetes after adjusting for age, sex, race/ethnicity, body mass index, physical activity, and measures of socioeconomic status.

Individuals with IFG who developed type 2 diabetes had more incident cardiovascular events, but this association disappeared in the full multivariable model.

“With the increasing incidence of obesity and therefore impaired fasting glucose (prediabetes), considering prediabetes as a cardiovascular risk factor if they actually are not, at least not until they (evolve to) diabetes, has both economic and patient safety issues,” Dr. Yeboah said. “Public health efforts should be concentrated on reducing the incidence of diabetes in this group and not reducing their cardiovascular risk.”

J Am Coll Cardiol 2011