title: Impact of prediabetic status on coronary atherosclerosis: a multivessel angioscopic study.
abstract: OBJECTIVE
  To determine if prediabetes is associated with atherosclerosis of coronary arteries, we evaluated the degree of coronary atherosclerosis in nondiabetic, prediabetic, and diabetic patients by using coronary angioscopy to identify plaque vulnerability based on yellow color intensity.
  
  
  METHODS
  Sixty-seven patients with coronary artery disease (CAD) underwent angioscopic observation of multiple main-trunk coronary arteries. According to the American Diabetes Association guidelines, patients were divided into nondiabetic (n = 16), prediabetic (n = 28), and diabetic (n = 23) groups. Plaque color grade was defined as 1 (light yellow), 2 (yellow), or 3 (intense yellow) based on angioscopic findings. The number of yellow plaques (NYPs) per vessel and maximum yellow grade (MYG) were compared among the groups.
  
  
  RESULTS
  Mean NYP and MYG differed significantly between the groups (P = 0.01 and P = 0.047, respectively). These indexes were higher in prediabetic than in nondiabetic patients (P = 0.02 and P = 0.04, respectively), but similar in prediabetic and diabetic patients (P = 0.44 and P = 0.21, respectively). Diabetes and prediabetes were independent predictors of multiple yellow plaques (NYPs ≥2) in multivariate logistic regression analysis (odds ratio [OR] 10.8 [95% CI 2.09-55.6], P = 0.005; and OR 4.13 [95% CI 1.01-17.0], P = 0.049, respectively).
  
  
  CONCLUSIONS
  Coronary atherosclerosis and plaque vulnerability were more advanced in prediabetic than in nondiabetic patients and comparable between prediabetic and diabetic patients. Slight or mild disorders in glucose metabolism, such as prediabetes, could be a risk factor for CAD, as is diabetes itself.
authors.affiliation: Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kurihara
authors.forename: Masamichi
authors.initials: M
authors.lastname: Takano
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shirakabe
authors.forename: Nakahisa
authors.initials: N
authors.lastname: Kimata
authors.forename: Toru
authors.initials: T
authors.lastname: Inami
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Ryo
authors.initials: R
authors.lastname: Munakata
authors.forename: Daisuke
authors.initials: D
authors.lastname: Murakami
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Inami
authors.forename: Kentaro
authors.initials: K
authors.lastname: Okamatsu
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohba
authors.forename: Chikao
authors.initials: C
authors.lastname: Ibuki
authors.forename: Noritake
authors.initials: N
authors.lastname: Hata
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Seino
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D017546:Angioscopy / Q000379:methods*; D003324:Coronary Artery Disease / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000150:complications* / Q000503:physiopathology*