title: A dysregulation of glucose metabolism control is associated with carotid atherosclerosis in patients with coronary heart disease (CORDIOPREV-DIAB study).
abstract: Patients with coexisting coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM) are at high risk of cardiovascular recurrence, however, it is not well established whether they exhibit an increased intima-media thickness of both common carotid arteries (IMT-CC). Furthermore, whether this relationship is inherent to T2DM or depends on glycemic control has not been tested in large cohorts. Our aim was to determine whether clinical categories and/or analytical markers of glucose metabolism control were associated with IMT-CC in CHD patients.
  
  
  
  1002 patients aged 20-75 years, categorized into normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or T2DM, underwent an oral glucose tolerance test (OGTT) and an IMT-CC measurement.
  
  
  
  IMT-CC was higher in T2DM patients with HbA1c > 6.5% compared to T2DM patients with HbA1c < 6.5% (p = 0.001), patients with IFG or IGT (p < 0.001) and NGT (p < 0.001). When age was considered, IMT-CC was influenced by glucose metabolism control only in e patients with age <61 years (p < 0.01). In a multiple linear regression analysis, glucose concentration at 120 min, but not other OGTT time-points appeared as a significant independent contributor of IMT-CC (p < 0.001). Moreover, a multiple logistic regression and the area under curve (AUC) of the ROC curve analysis showed a predictive power of glucose at 120 min to detect those CHD patients at the highest risk, defined as IMT-CC ≥ 0.7 mm (R2= 0.221; AUC = 0.761).
  
  
  
  Our results highlight the importance of properly controlling glucose metabolism in CHD patients, in younger populations in particular, providing an easy way of categorizing patients with an increased IMT-CC. Moreover, glucose concentration at 120 min could contribute to CVD risk and its determination could be used as a predictive tool to identify those CHD patients at the highest risk.
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: Elena M
authors.initials: EM
authors.lastname: Yubero-Serrano
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain. Electronic address: delgadolista@gmail.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Delgado-Lista
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Alcala-Diaz
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Garcia-Rios
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: Ana I
authors.initials: AI
authors.lastname: Perez-Caballero
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: Ruth
authors.initials: R
authors.lastname: Blanco-Rojo
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Gomez-Delgado
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Marin
authors.affiliation: Biomedical Research Institute of Malaga (IBIMA), Virgen de la Victoria Hospital, University of Malaga, Malaga, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Tinahones
authors.affiliation: Clinical Analysis Service, Reina Sofía University Hospital, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Caballero
authors.affiliation: Nutrition and Genomics Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Ordovas
authors.affiliation: TNO, Zeist, The Netherlands.
authors.forename: Ben
authors.initials: B
authors.lastname: van Ommen
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Perez-Jimenez
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Perez-Martinez
authors.affiliation: Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain. Electronic address: jlopezmir@uco.es.
authors.forename: Jose
authors.initials: J
authors.lastname: Lopez-Miranda
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002339:Carotid Arteries / Q000473:pathology; D002340:Carotid Artery Diseases / Q000097:blood* / Q000150:complications; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000150:complications; D003327:Coronary Disease / Q000097:blood* / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D005260:Female; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000150:complications; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Age; Coronary heart disease; Glycemic control; Intima media thickness; OGTT; Posprandial glycemia