Post-challenge glucose predicts coronary atherosclerotic progression in non-diabetic, post-menopausal women.
OBJECTIVE
We sought to determine whether fasting or post-challenge glucose were associated with progression of coronary atherosclerosis in non-diabetic women.


METHODS
We performed a post-hoc analysis of 132 non-diabetic women who underwent 75-g oral glucose tolerance testing. The primary outcome of interest was progression of atherosclerosis determined by baseline and follow-up coronary angiography, a mean of 3.1 +/- 0.9 years apart. We analysed the association of change in minimal vessel diameter (DeltaMD) by quartile of fasting and post-challenge glucose using mixed models that included adjustment for age, systolic blood pressure, total : high-density lipoprotein cholesterol ratio, current smoking, lipid-lowering and anti-hypertensive medication use and other covariates.


RESULTS
At baseline, participants had a mean age of 65.7 +/- 6.7 years and a mean body mass index of 27.9 +/- 8.5 kg/m(2). Although there were no significant differences in atherosclerotic progression by fasting glucose category (P for trend across quartiles = 0.99), there was a significant inverse association between post-challenge glucose and DeltaMD (in mm) (Q1 : 0.01 +/- 0.03; Q2 : 0.08 +/- 0.03; Q3 : 0.13 +/- 0.03; Q4 : 0.11 +/- 0.03; P for trend = 0.02).


CONCLUSIONS
In post-menopausal women without diabetes, post-challenge glucose predicts angiographic disease progression. These findings suggest that even modest post-challenge hyperglycaemia influences the pathogenesis of atherosclerotic progression.
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. pmellen@wfubmc.edu
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Mellen
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Bittner
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Herrington
D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D017698:Postmenopause; D011237:Predictive Value of Tests; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose