Association between impaired glucose tolerance and carotid atherosclerosis: a study in 64-year-old women and a meta-analysis.
OBJECTIVE
Impaired glucose tolerance (IGT) is regarded as a transient metabolic state leading to type-2 diabetes, and is known to predict future risk of cardiovascular disease. This study was designed to investigate if IGT is associated with subclinical atherosclerosis.


RESULTS
In a population-based cohort of 64-year-old women, a group with IGT determined by repeated oral glucose tolerance tests (n=205) was compared with healthy women with normal glucose tolerance (NGT, n=188). Intima-media thickness (IMT) and plaques in the common carotid arteries (CCA) and bulbs were measured by ultrasound. The 95% confidence interval (CI) of the difference between the IGT and NGT groups was -0.03 to 0.03mm. There was no difference in carotid bulb IMT or in the occurrence, size, and characteristics of plaques between the IGT and NGT groups. A meta-analysis was used to calculate summary measures of 12 reviewed studies showing a difference of 0.030 (95% CI 0.012-0.048) mm in carotid IMT between IGT and NGT groups. Heterogeneity in IMT differences between studies was shown.


CONCLUSIONS
In our population-based cohort of 64-year-old women, IGT was not associated with increased occurrence of subclinical atherosclerosis. However, a meta-analysis of 12 studies, including our current study, showed that IGT was associated with a small increase in the CCA IMT.
Brohall
G
G
Wallenberg Laboratory for Cardiovascular Research, Academy at Göteborg University, Sahlgrenska University Hospital, Gothenburg, Sweden. brohall@wlab.gu.se
Schmidt
C
C
Behre
C J
CJ
Hulthe
J
J
Wikstrand
J
J
Fagerberg
B
B
D002340:Carotid Artery Diseases / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*; D014463:Ultrasonography