title: Cardiovascular risk profile in subjects with prediabetes and new-onset type 2 diabetes identified by HbA(1c) according to American Diabetes Association criteria.
abstract: OBJECTIVE
  We investigated the cardiovascular risk profile in subjects with prediabetes and new-onset type 2 diabetes identified by glycated hemoglobin A1c (HbA(1c)) according to the new American Diabetes Association criteria.
  
  
  METHODS
  Arterial stiffness, intima-media thickness (IMT), soluble receptor for advanced glycation end products (sRAGEs), and oral glucose tolerance test (OGTT) were evaluated in 274 subjects without a previous history of diabetes. The subjects were stratified into three groups according to the HbA(1c) levels.
  
  
  RESULTS
  The subjects with prediabetes (n = 117, HbA(1c) 5.7-6.4% [39-46 mmol/mol]) showed a higher augmentation (Aug), augmentation index (AugI), and IMT compared with those with lower HbA1c; however, these values were similar to those of subjects with HbA(1c) >6.5% (48 mmol/mol). When we further analyzed the subjects with prediabetes but included only subjects with normal glucose tolerance (NT) in the analysis, AugI and IMT still remained significantly higher than their levels in control subjects with HbA(1c) <5.7% (39 mmol/mol). After multiple regression analyses including several cardiovascular risk factors, only HbA(1c), age, and sRAGE were significantly correlated with the IMT, whereas age and 1-h postload glucose were the major determinants of AugI.
  
  
  CONCLUSIONS
  Our data show that subjects with prediabetes according to HbA1c, but with both NT according to the OGTT and normal fasting glycemia, have an altered IMT and AugI. These data suggest that a simple, reproducible, and less expensive marker such as HbA1c may be better able to identify prediabetic subjects at high cardiovascular risk compared with fasting glycemia or OGTT alone.
authors.affiliation: Corresponding author: Francesco Purrello, fpurrell@unict.it.
authors.forename: Antonino
authors.initials: A
authors.lastname: Di Pino
authors.forename: Roberto
authors.initials: R
authors.lastname: Scicali
authors.forename: Salvatore
authors.initials: S
authors.lastname: Calanna
authors.forename: Francesca
authors.initials: F
authors.lastname: Urbano
authors.forename: Concetta
authors.initials: C
authors.lastname: Mantegna
authors.forename: Agata Maria
authors.initials: AM
authors.lastname: Rabuazzo
authors.forename: Francesco
authors.initials: F
authors.lastname: Purrello
authors.forename: Salvatore
authors.initials: S
authors.lastname: Piro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology*; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood; D012307:Risk Factors; D014481:United States; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic