Marco Matteo Ciccone, Francesca Cortese, Michele Gesualdo, Ilaria Donvito, Santa Carbonara and Giovanni De Pergola Pages 288 - 295 ( 8 )
Background: Alterations of glucose metabolism represent well known risk factors for the atherosclerotic process and then for cardiovascular disease.Objective: To investigate the association between fasting glucose and early signs of atherosclerosis, by means of carotid intima-media thickness (c-IMT) in a population of apparently healthy overweight/obese subjects. In addition, we evaluated the possible existence of a glycemic threshold above which the risk of atherosclerosis significantly increases. Methods: 179 overweight/obese (mean BMI: 32 ± 5 kg/m2) subjects, 44 men, aged 40 ± 12.4 years, were enrolled in the study. Blood glucose, insulin, total cholesterol, high and low density lipoprotein cholesterol and triglycerides were detected in all subjects. The Homeostasis Model Assessment of insulin resistance index (HOMA-IR) was also obtained. All subjects underwent carotid echo color Doppler ultrasound to identify c-IMT. Results: In our population of obese/overweight subjects with insulin resistance (HOMA-IR=3.4 ± 2), c- IMT was positively related to male gender (r = 0.23, P<0.01), age (r = 0.53, P<0.001), waist circumference (r = 0.15, P=0.04), systolic and diastolic blood pressure (r=0.27, P<0.001 and r=0.24, P<0.001 respectively), fasting glucose (r=0.29, P<0.001), triglycerides (r= 0.16 P=0.03), total and low density lipoprotein cholesterol levels (r=0.25 P<0.001 and r=0.21, P<0.01 respectively). Only male gender and fasting glycemia were associated to c-IMT (P<0.01 and P< 0.001, respectively) at multiple regression analysis. Conclusion: Blood glucose represented an independent predictor of atherosclerosis in our study population. Moreover, this seemed to be able to favor c-IMT progression for values greater than 90 mg/dl.
Atherosclerosis, carotid intima-media thickness, glucose, obesity, overweight.
Cardiovascular disease Section, Department of Organ and Trasplantation, University of Bari