title: Clinical and metabolic characteristics of treated hyperlipidemic patients additionally affected by subclinical hyperglycemia.
abstract: BACKGROUND
  Impaired glucose regulation (IGR) and hyperlipidemia (HL) are associated with an increased risk of developing a cardiovascular disease. Hyperlipidemic patients were shown to bear a greater risk for an increased intima media thickness (IMT). However little is known about differences between treated hyperlipidemic patients (HL) with normal (NGR) or impaired (IGR) glucose regulation.
  
  
  METHODS
  We performed a cross-sectional study, involving 96 non-diabetic HL patients with IGR (fasting plasma glucose of ≥ 100 mg/dl and < 126 mg/dl or/and HbA1c-level of ≥ 5.7 and < 6.5 %) or with NGR (HbA1c-level of < 5.7 % and a fasting glucose < 100 mg/dl). We compared metabolic characteristics and the IMT between the two groups. Insulin sensitivity in fasting conditions was described by HOMA-IR and QUICKI.
  
  
  RESULTS
  HL-IGR patients were older (57.6 ± 10.4 vs. 49.1 ± 8.7, p < 0.001), had higher carotid IMT measurements (IMT average: 0.68 ± 0.14 vs. 0.60 ± 0.09, p = 0.002; IMT right: 0.67 ± 0.15 vs. 0.60 ± 0.10, p = 0.013; IMT left: 0.63 vs. 0.57, p = 0.009), as well as a higher chance to exceed a cut-off value of ≥ 0.8 mm or insignificant stenosis within this investigation (OR: 3.9, 95 % CI: 1.15-13.22, p = 0.029) compared to HL-NGR-patients. Furthermore HL-IGR patients were characterised by a higher waist circumference (100.6 ± 10.1 vs. 91.6 ± 13.3, p < 0.001), higher fasting plasma glucose-levels (100.1 ± 10.8 vs. 88.1 ± 6.6, p < 0.001), higher HbA1c concentrations (5.8 ± 0.33 vs. 5.3 ± 0.24, p < 0.001) and C-peptide levels (2.70 vs. 2.10, p = 0.012). Age and CVD status were in general the only two variables which independently explained IMT.
  
  
  CONCLUSIONS
  Our study showed that among patients with treated hyperlipidemia the presence of IGR characterised subjects who were older and had a significantly higher risk for an increased IMT compared with those maintaining NGR. Further studies are necessary to evaluate if this specific subpopulation with IGR can benefit from a more strict multifactorial management and perhaps from an additional early antihyperglycaemic treatment.
authors.affiliation: Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. michael.leutner@meduniwien.ac.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Leutner
authors.affiliation: Department of Gynecology and Obstetrics, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. christian.goebl@meduniwien.ac.at.
authors.forename: Christian
authors.initials: C
authors.lastname: Göbl
authors.affiliation: Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. alice.wielandner@meduniwien.ac.at.
authors.forename: Alice
authors.initials: A
authors.lastname: Wielandner
authors.affiliation: Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. eleonora.howorka@gmail.com.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Howorka
authors.affiliation: Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. marlies.pruenner@gmx.net.
authors.forename: Marlies
authors.initials: M
authors.lastname: Prünner
authors.affiliation: Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. latife.bozkurt@meduniwien.ac.at.
authors.forename: Latife
authors.initials: L
authors.lastname: Bozkurt
authors.affiliation: Department of Internal Medicine II, Division of Angiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. oliver.schlager@meduniwien.ac.at.
authors.forename: Oliver
authors.initials: O
authors.lastname: Schlager
authors.affiliation: Department of Internal Medicine II, Division of Angiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. silvia.charwat@gmx.at.
authors.forename: Silvia
authors.initials: S
authors.lastname: Charwat-Resl
authors.affiliation: Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. alexandra.kautzky-willer@meduniwien.ac.at.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
mesh_terms: D000367:Age Factors; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000378:metabolism*; D006949:Hyperlipidemias / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged