title: Cardiometabolic risk profiles and carotid atherosclerosis in individuals with prediabetes identified by fasting glucose, postchallenge glucose, and hemoglobin A1c criteria.
abstract: OBJECTIVE
  We evaluated whether cardiometabolic risk profiles differ for subjects identified as having prediabetes by A1C, fasting glucose (FPG), or 2-h postchallenge glucose (2-PG) criteria.
  
  
  METHODS
  Atherosclerosis risk factors, oral glucose tolerance test, and ultrasound measurement of carotid intima-media thickness (IMT) were analyzed in 780 nondiabetic individuals.
  
  
  RESULTS
  Poor agreement existed for A1C and FPG criteria for identification of subjects with prediabetes (κ coefficient = 0.332). No differences in cardiometabolic risk profiles were observed among the three groups of individuals with prediabetes by A1C only, FPG only, and both A1C and FPG. Poor agreement also existed for A1C and 2-PG criteria for identification of individuals with prediabetes (κ coefficient = 0.299). No significant differences in cardiometabolic risk factors were observed between IGT-only and individuals with prediabetes by A1C and 2-PG. Compared with subjects with prediabetes identified by A1C only, IGT-only individuals exhibited a worse cardiometabolic risk profile, with significantly higher systolic blood pressure, pulse pressure, 2-h postchallenge insulin, triglycerides, high-sensitivity C-reactive protein, and carotid IMT, and lower HDL cholesterol levels and insulin sensitivity.
  
  
  CONCLUSIONS
  These results suggest that considerable discordance between A1C, FPG, and 2-PG exists for the identification of individuals with prediabetes and that the cardiometabolic risk profile of these individuals varies by metabolic parameter, with 2-PG showing the stronger association with cardiometabolic risk factors and subclinical atherosclerosis than FPG or A1C.
authors.affiliation: Department of InternalMedicine, University of Rome-Tor Vergata, Rome, Italy.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Marini
authors.forename: Elena
authors.initials: E
authors.lastname: Succurro
authors.forename: Ersilia
authors.initials: E
authors.lastname: Castaldo
authors.forename: Sabrina
authors.initials: S
authors.lastname: Cufone
authors.forename: Franco
authors.initials: F
authors.lastname: Arturi
authors.forename: Angela
authors.initials: A
authors.lastname: Sciacqua
authors.forename: Renato
authors.initials: R
authors.lastname: Lauro
authors.forename: Marta L
authors.initials: ML
authors.lastname: Hribal
authors.forename: Francesco
authors.initials: F
authors.lastname: Perticone
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sesti
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002340:Carotid Artery Diseases / Q000097:blood* / Q000453:epidemiology* / Q000378:metabolism; D005215:Fasting / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood* / Q000453:epidemiology* / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin