Issue 109 Item 6 Fasting Glucose Inadequate in Screening for CV Risk

Two-thirds of subjects with cardiovascular risk factors remain undetected using fasting glucose testing as a screening method, say researchers. Fasting glucose inadequate in screening for CV risk

The researchers used a two-step strategy to compare metabolic risk profiles in subjects with impaired glucose fasting (IFG) and those with impaired glucose tolerance (IGT). They identified 1,855 people without diagnosed diabetes with fasting plasma glucose of between 5.6-7.8 mmol/l. Those patients were asked to complete an oral glucose tolerance test (OGTT; n=1,456).

The results between the two measurements only agreed in 20.8% of the subjects. Those with isolated IFG did not have clinical features associated with cardiovascular risk, whereas subjects with IGT had associated cardiovascular risk profiles. The researchers commented that if IFG were used for glucose intolerance screening about 66.6% of subjects with IGT with cardiovascular risk would not have been detected.

Li CL et al. Comparison of metabolic risk profiles between subjects with fasting and 2-hour plasma glucose impairment: The Kinmen Study. J Clin Epidemiol 2002; 55: 19-24.