Glucose and non-glucose predictors of future onset of type 2 diabetes in newly diagnosed essential hypertensives.
BACKGROUND
Baseline fasting plasma glucose (FPG) level predicts the onset of type 2 diabetes mellitus (DM). Other predictors have been less investigated. This study aimed to investigate non-glucose predictors together with FPG for future onset of type 2 DM in fresh essential hypertensives.


METHODS
Consecutive nondiabetic patients with newly diagnosed essential hypertension were prospectively evaluated for diurnal blood pressure (BP) change by ambulatory BP monitoring, vascular endothelial function by plethysmography, and biomarkers by blood biochemistry. They were then given guideline-based treatment and followed-up regularly for more than 5 years.


RESULTS
During a mean follow-up period of 5.9 years, 6 of the 106 study patients developed DM. Baseline FPG, alanine aminotransferase (ALT) level, and day-night difference in diastolic BP were related to future onset of DM. FPG > 5.8 mmol/L (p = 0.034) and ALT > 31 U/L (p = 0.048) independently and day-night difference in diastolic BP < or = 2.9% potentially predicted new-onset DM (p = 0.089). Simultaneously having at least 2 of the indicators mentioned above at baseline is predictive of new-onset DM. Parameters of reactive hyperemia by plethysmography were not relevant.


CONCLUSIONS
In addition to FPG, baseline serum ALT level independently and diurnal diastolic BP changes potentially predicted future onset of type 2 DM in newly diagnosed hypertensives. Both glucose and non-glucose indicators could be examined together for early risk stratification of future DM.
Fong
Man-Cai
MC
Division of Cardiology, Department of Medicine, Taipei Hospital, Department of Health, Taipei, Taiwan, R.O.C.
Huang
Chin-Chou
CC
Leu
Hsin-Bang
HB
Wu
Tao-Cheng
TC
Lin
Shing-Jong
SJ
Chen
Jaw-Wen
JW
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D018660:Blood Pressure Monitoring, Ambulatory; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors
D001786:Blood Glucose; D000410:Alanine Transaminase