title: Novel biomarkers of cardiometabolic risk are associated with plasma glucose within non-diabetic range. The Brazilian Longitudinal Study of Adult Health - ELSA-Brasil.
abstract: Abnormal glucose metabolism preceding overt diabetes is associated with increased cardiovascular risk. Whether novel biomarkers are useful to identify this condition is unclear. The objective was to investigate associations of biomarkers of atherogenesis with plasma glucose within non-diabetic range. 998 participants (35-54 years) of the Brazilian Longitudinal Study of Adult Health without diabetes or cardiovascular disease were classified as normal glucose tolerance (NGT), impaired fasting glycemia (IFG) and impaired glucose tolerance (IGT). Traditional risk factors and markers of atherogenesis were evaluated among groups and across plasma glucose concentrations. IFG and IGT had worse profile considering traditional cardiovascular risk factors than the NGT group, although these values were within the reference range. NGT, IFG and IGT groups differed (medians and interquartile intervals) regarding transforming growth factor-β1 [12.2 (6.4-22.3), 16.8 (8.4-26.5), and 15.5 (8.0-26.1)pg/mL, p<0.05], C-reactive protein [1.1 (0.6-2.9), 1.2 (0.6-2.7), and 1.4 (0.8-3.7)ng/mL, p<0.001] and monocyte chemoattractant protein-1 [35.9 (21.2-57.8), 32.2 (18.7-55.8), and 34.1 (18.6-52.4)pg/mL, p<0.05]. TGF-β1 and E-selectin concentrations increased while MCP-1 decreased across quartiles of fasting plasma glucose. C-reactive protein increased with increments in 2-h plasma glucose. In linear regression, TGF-β1 was independently associated with fasting plasma glucose, and C-reactive protein with 2-h plasma glucose after adjustments. In conclusion, association of TGF-β1, E-selectin, C-reactive protein and MCP-1 with slight elevations in glycemia may be anticipating alterations in traditional cardiovascular risk factors. Independent association of TGF-β1 with plasma glucose suggests that this may be useful to identifying atherogenic process, deserving further investigation on the prediction of cardiovascular outcomes.
authors.affiliation: School of Public Health, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Bianca
authors.initials: B
authors.lastname: Almeida-Pititto
authors.affiliation: Medicine Department, Federal University of Pará, Belem, PA, Brazil.
authors.forename: Fernando F
authors.initials: FF
authors.lastname: Ribeiro-Filho
authors.affiliation: Center of Clinical and Epidemiologic Research, University Hospital, University of São Paulo, SP, Brazil.
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
authors.affiliation: Center of Clinical and Epidemiologic Research, University Hospital, University of São Paulo, SP, Brazil.
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Bensenor
authors.affiliation: School of Public Health, University of São Paulo, São Paulo, SP, Brazil. Electronic address: sandrafv@usp.br.
authors.forename: Sandra R G
authors.initials: SR
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D001938:Brazil / Q000453:epidemiology; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D018932:Chemokine CCL2 / Q000097:blood; D019040:E-Selectin / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000453:epidemiology*; D012307:Risk Factors; D053773:Transforming Growth Factor beta1 / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D019040:E-Selectin; C546936:SELE protein, human; D053773:Transforming Growth Factor beta1; D002097:C-Reactive Protein
keywords: Atherogenesis; Biomarkers; Cardiometabolic risk; Inflammation; Pre-diabetes