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Al Rifai M, Al-Mallah MH, Blaha MJ, Patel J, McEvoy JW, Nasir K, Shahid I, Patel KV, Sharma G, Marrugat J, Tizon-Marcos H, Erbel R, Stang A, Jöckel KH, Lehmann N, Schramm S, Schmidt B, Blumenthal RS, Virani SS, Nambi V, Cainzos-Achirica M. Epidemiology and Prognostic Implications of Coronary Artery Calcium in Asymptomatic Individuals With Prediabetes: A Multicohort Study. Diabetes Care 2024; 47:698-706. [PMID: 38329795 DOI: 10.2337/dc23-1864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To describe the epidemiology and prognostic value of coronary artery calcium (CAC) in individuals with prediabetes. RESEARCH DESIGN AND METHODS We pooled participants free of clinical atherosclerotic cardiovascular disease (ASCVD) from four prospective cohorts: the Multi-Ethnic Study of Atherosclerosis, Heinz Nixdorf Recall Study, Framingham Heart Study, and Jackson Heart Study. Two definitions were used for prediabetes: inclusive (fasting plasma glucose [FPG] ≥100 to <126 mg/dL and hemoglobin A1c [HbA1c] ≥5.7% to <6.5%, if available, and no glucose-lowering medications) and restrictive (FPG ≥110 to <126 mg/dL and HbA1c ≥5.7% to <6.5%, if available, among participants not taking glucose-lowering medications). RESULTS The study included 13,376 participants (mean age 58 years; 54% women; 57% White; 27% Black). The proportions with CAC ≥100 were 17%, 22%, and 37% in those with euglycemia, prediabetes, and diabetes, respectively. Over a median (25th-75th percentile) follow-up time of 14.6 (interquartile range 7.8-16.4) years, individuals with prediabetes and CAC ≥100 had a higher unadjusted 10-year incidence of ASCVD (13.4%) than the overall group of those with diabetes (10.6%). In adjusted analyses, using the inclusive definition of prediabetes, compared with euglycemia, the hazard ratios (HRs) for ASCVD were 0.79 (95% CI 0.62, 1.01) for prediabetes and CAC 0, 0.70 (0.54, 0.89) for prediabetes and CAC 1-99, 1.54 (1.27, 1.88) for prediabetes and CAC ≥100, and 1.64 (1.39, 1.93) for diabetes. Using the restrictive definition, the HR for ASCVD was 1.63 (1.29, 2.06) for prediabetes and CAC ≥100. CONCLUSIONS CAC ≥100 is frequent among individuals with prediabetes and identifies a high ASCVD risk subgroup in which the adjusted ASCVD risk is similar to that in individuals with diabetes.
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Affiliation(s)
| | | | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD
| | - Jaideep Patel
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD
- Johns Hopkins Heart Center, Greater Baltimore Medical Center, Baltimore, MD
| | - John W McEvoy
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD
- National Institute for Prevention and Cardiovascular Health, Galway, Ireland
| | - Khurram Nasir
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX
- Houston Methodist Academic Institute, Houston, TX
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX
- Center for Outcomes Research, Houston Methodist, Houston, TX
| | - Izza Shahid
- Houston Methodist Academic Institute, Houston, TX
| | - Kershaw V Patel
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX
- Houston Methodist Academic Institute, Houston, TX
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX
- Center for Outcomes Research, Houston Methodist, Houston, TX
| | - Garima Sharma
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD
- Inova Women's Cardiovascular Health, Fairfax, VA
| | - Jaume Marrugat
- Hospital del Mar, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
| | - Helena Tizon-Marcos
- Hospital del Mar, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Nils Lehmann
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD
| | - Salim S Virani
- Aga Khan University, Karachi, Pakistan
- Texas Heart Institute, Houston, TX
- Baylor College of Medicine, Houston, TX
| | - Vijay Nambi
- Section of Cardiology, Baylor College of Medicine, Houston, TX
- Center for Cardiometabolic Disease Prevention, Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
| | - Miguel Cainzos-Achirica
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD
- Hospital del Mar, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
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Kim YC, Um YJ, Yoon SH, Kim TW, Seo HJ, Jeong JH, Hong SC, Um YH. Association between weekend catch-up sleep and the risk of prediabetes and diabetes: A cross-sectional study using KNHANES. J Psychosom Res 2024; 179:111618. [PMID: 38412653 DOI: 10.1016/j.jpsychores.2024.111618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/16/2024] [Accepted: 02/17/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND The objectives of this cross-sectional study were to explore the relationship between weekend catch-up sleep (WCUS) and the risk of prediabetes/diabetes and to assess how this risk varies based on WCUS duration, using a large population sample in South Korea. METHODS Data were sourced from the 2021 Korea National Health and Nutrition Examination Survey, involving 2472 subjects aged 30 years and above, employed, and not using blood glucose-lowering medications. Prediabetes/diabetes risk was examined based on the presence of WCUS. Participants were categorized into four groups by WCUS duration (< 1, ≥ 1 and < 2, ≥ 2 and < 3, and ≥ 3 h) to evaluate the prediabetes/diabetes risk across varying WCUS durations. RESULTS No significant difference in prediabetes/diabetes risk was observed between the WCUS and non-WCUS groups. In subgroup analysis, a WCUS duration of 1 to 2 h was related to a lower odds ratio of prediabetes (aOR = 0.618, 95% CI = 0.382-0.999), while 3 h or more was associated with a higher odds ratio of diabetes (aOR = 3.098, 95% CI = 1.561-6.149). CONCLUSIONS In individuals who experience insufficient sleep during weekdays and manage to achieve the optimal average sleep duration of 1 to 2 h of WCUS, WCUS was associated with improved blood glucose regulation. However, compensating for excessive weekday sleep deprivation with WCUS of 3 h or more was associated with impaired blood glucose regulation.
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Affiliation(s)
- Young-Chan Kim
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Jin Um
- Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi-do, Republic of Korea
| | - Sung Hoon Yoon
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Tae-Won Kim
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho Jun Seo
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung-Chul Hong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Cai C, Wang L, Chen Q, Lin M, Pan X, Chen W, Shi D, Chen Y. Association between hemoglobin A1c and abdominal aortic calcification: results from the National Health and Nutrition Examination Survey 2013-2014. BMC Cardiovasc Disord 2024; 24:26. [PMID: 38172671 PMCID: PMC10765683 DOI: 10.1186/s12872-023-03700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Hemoglobin A1c (HbA1c), a "gold standard" for the assessment of glycemic control, was associated with an increased risk of cardiovascular disease and coronary artery calcification. However, its effects on abdominal aortic calcification (AAC) are uncertain. The present study comprehensively investigated the association between HbA1c and AAC in the 2013-2014 National Health and Nutrition Examinations Surveys. METHODS Among 1,799 participants ≥ 40 years, dual-energy X-ray absorptiometry-derived AAC was quantified using the Kauppila score (AAC-24). Severe AAC was defined as a total AAC-24 > 6. Weighted linear regression models and logistic regression models were used to determine the effects of HbA1c on AAC. The restricted cubic spline model was used for the dose-response analysis. RESULTS The mean AAC-24 of participants was 1.3, and 6.7% of them suffered from severe AAC. Both AAC-24 and the prevalence of severe AAC increased with the higher tertile of HbA1c (P < 0.001). Elevated HbA1c levels would increase the AAC-24 (β = 0.73, 95% CI: 0.30-1.16) and the risk of severe AAC (OR = 1.63, 95% CI: 1.29-2.06), resulting in nearly linear dose-response relationships in all participants. However, this positive correlation were not statistically significant when participants with diabetes were excluded. Furthermore, subgroup analysis showed significant interactions effect between HbA1c and hypertension on severe AAC with the OR (95% CI) of 2.35 (1.62-3.40) for normotensives and 1.39 (1.09-1.79) for hypertensives (P for interaction = 0.022). CONCLUSION Controlling HbA1c could reduce AAC scores and the risk of severe AAC. Glycemic management might be a component of strategies for preventing AAC among all participants, especially normotensives.
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Affiliation(s)
- Can Cai
- Scientific Research and Innovation Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Lingsong Wang
- Scientific Research and Innovation Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Quanyao Chen
- Scientific Research and Innovation Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Min Lin
- Scientific Research and Innovation Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Xiuming Pan
- Scientific Research and Innovation Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Weida Chen
- Scientific Research and Innovation Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Danni Shi
- Scientific Research and Innovation Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Yao Chen
- Scientific Research and Innovation Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, China.
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Zhu Y, Zou H, Guo Y, Luo P, Meng X, Li D, Xiang Y, Mao B, Pan L, Kan R, He Y, Li W, Liu Z, Yang Y, Xie J, Zhang B, Zhou X, Hu S, Yu X. Associations between metabolic score for visceral fat and the risk of cardiovascular disease and all-cause mortality among populations with different glucose tolerance statuses. Diabetes Res Clin Pract 2023; 203:110842. [PMID: 37495020 DOI: 10.1016/j.diabres.2023.110842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/15/2023] [Accepted: 07/24/2023] [Indexed: 07/28/2023]
Abstract
AIMS To investigate the associations between metabolic score for visceral fat (METS-VF) and clinical outcomes among populations with different glucose tolerance statuses. METHODS We analysed 6827 participants aged ≥ 40 years with different glucose tolerance statuses from a cohort study. The associations between METS-VF and cardiovascular disease (CVD) events and all-cause mortality were assessed using Cox regression, restricted cubic spline and receiver operating characteristic curves. RESULTS During a follow-up of 5.00 years, there were 338 CVD events and 307 subjects experienced all-cause death. The METS-VF quartile (Quartile 4 versus 1) was significantly related to CVD events [adjusted HRs and 95% CIs: 5.75 (2.67-12.42), 2.80 (1.76-4.48), and 3.31 (1.28-8.54) for subjects with normal glucose tolerance, prediabetes and diabetes, respectively] and all-cause mortality [adjusted HRs and 95% CIs: 2.80 (1.43-5.49), 4.15 (2.45-7.01), and 4.03 (1.72-9.42), respectively]. Restricted cubic spline suggested a dose-response association of METS-VF with the risk of CVD events and all-cause mortality. The area under curve for CVD events and all-cause mortality was higher for METS-VF than for the other obesity and IR indexes in subjects with different glucose tolerance statuses. CONCLUSIONS The METS-VF was associated with an increased risk of CVD events and all-cause mortality and could be used as a predictive index of the risk of CVD events and all-cause mortality among populations with different glucose tolerance statuses.
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Affiliation(s)
- Yurong Zhu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Huajie Zou
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Division of Endocrinology, Department of Internal Medicine, The Affiliated Hospital of Qinghai University, Xining 810001, China
| | - Yaming Guo
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Peiqiong Luo
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiaoyu Meng
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Danpei Li
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yuxi Xiang
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Beibei Mao
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Limeng Pan
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ranran Kan
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yi He
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wenjun Li
- Computer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhelong Liu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Branch of National Clinical Research Center for Metabolic Diseases, Wuhan 430030, China
| | - Yan Yang
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Branch of National Clinical Research Center for Metabolic Diseases, Wuhan 430030, China
| | - Junhui Xie
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Branch of National Clinical Research Center for Metabolic Diseases, Wuhan 430030, China
| | - Benping Zhang
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Branch of National Clinical Research Center for Metabolic Diseases, Wuhan 430030, China
| | - Xinrong Zhou
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Branch of National Clinical Research Center for Metabolic Diseases, Wuhan 430030, China
| | - Shuhong Hu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Branch of National Clinical Research Center for Metabolic Diseases, Wuhan 430030, China
| | - Xuefeng Yu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Branch of National Clinical Research Center for Metabolic Diseases, Wuhan 430030, China.
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Marjanovic Petkovic M, Vuksanovic M, Sagic D, Radovic I, Soldatovic I, Beljic Zivkovic T. Risk Factors for Coronary Artery Calcifications in Overweight or Obese Persons with Prediabetes: Can They Predict T2 Diabetes and Coronary Vascular Events? J Clin Med 2023; 12:3915. [PMID: 37373609 DOI: 10.3390/jcm12123915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/29/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND It is difficult to predict the risk of developing atherosclerotic cardiovascular disease in subjects with prediabetes and obesity. The aim of this study was to assess risk factors for coronary artery calcifications (CACs) and the development of type 2 diabetes (T2D) and coronary vascular events (CVEs) after 7 years in 100 overweight or obese persons with prediabetes, according to the baseline coronary artery calcium score (CACS). METHODS Lipids, HbA1c, uric acid, and creatinine were assessed. Glucose, insulin, and c-peptide were determined during an oral glucose tolerance test. Multi-sliced computerized tomography with evaluation of CACS was performed. After 7 years, the subjects were assessed for T2D/CVE. RESULTS CACs were present in 59 subjects. No single biochemical marker could predict presence of a CAC. After 7 years, T2D developed in 55 subjects (61.8% initially had both IFG and IGT). A gain in weight was the only contributing factor for T2D. Nineteen subjects developed a CVE; increased initial clustering of HOMA-IR > 1.9, LDL > 2.6, and mmol/Land TGL > 1.7 mmol/L and higher CACS were present in that group. CONCLUSIONS No risk factors for CACs could be identified. A gain in weight is associated with T2D development, as are higher CACS and clustering of high LDL+TGL+HOMA-IR with CVEs.
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Affiliation(s)
- Milica Marjanovic Petkovic
- Division of Endocrinology Diabetes and Metabolic Disorders, Zvezdara University Medical Center, Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia
| | - Miljanka Vuksanovic
- Division of Endocrinology Diabetes and Metabolic Disorders, Zvezdara University Medical Center, Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia
| | - Dragan Sagic
- Cardiovascular Institute Dedinje, Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia
| | - Ivana Radovic
- Blood and Transfusion Institute of Serbia, 11000 Belgrade, Serbia
| | - Ivan Soldatovic
- Institute of Medical Statistics and Informatics, Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia
| | - Teodora Beljic Zivkovic
- Division of Endocrinology Diabetes and Metabolic Disorders, Zvezdara University Medical Center, Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia
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