title: Fasting glucose levels, incident diabetes, subclinical atherosclerosis and cardiovascular events in apparently healthy adults: A 12-year longitudinal study.
abstract: We aimed to study the association between fasting plasma glucose, diabetes incidence and cardiovascular burden after 10-12 years. We evaluated diabetes and cardiovascular events incidences, carotid intima-media thickness and coronary artery calcium scores in ELSA-Brasil (the Brazilian Longitudinal Study of Adult Health) baseline (2008-2010) of 1536 adults without diabetes in 1998. We used regression models to estimate association with carotid intima-media thickness (in mm), coronary artery calcium scores (in Agatston points) and cardiovascular events according to fasting plasma glucose in 1998. Adjusted diabetes incidence rate was 9.8/1000 person-years (95% confidence interval: 7.7-13.6/1000 person-years). Incident diabetes was positively associated with higher fasting plasma glucose. Fasting plasma glucose levels 110-125 mg/dL were associated with higher carotid intima-media thickness (β = 0.028; 95% confidence interval: 0.003-0.053). Excluding those with incident diabetes, there was a borderline association between higher carotid intima-media thickness and fasting plasma glucose 110-125 mg/dL (β = 0.030; 95% confidence interval: -0.005 to 0.065). Incident diabetes was associated with higher carotid intima-media thickness (β = 0.034; 95% confidence interval: 0.015-0.053), coronary artery calcium scores ⩾400 (odds ratio = 2.84; 95% confidence interval: 1.17-6.91) and the combined outcome of a coronary artery calcium scores ⩾400 or incident cardiovascular event (odds ratio = 3.50; 95% confidence interval: 1.60-7.65). In conclusion, fasting plasma glucose in 1998 and incident diabetes were associated with higher cardiovascular burden.
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Debora
authors.initials: D
authors.lastname: Sitnik
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Itamar S
authors.initials: IS
authors.lastname: Santos
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Alessandra C
authors.initials: AC
authors.lastname: Goulart
authors.affiliation: Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Henrique L
authors.initials: HL
authors.lastname: Staniak
authors.affiliation: Brigham and Women's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA.
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil isabensenor@hu.usp.br.
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Bensenor
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D001938:Brazil / Q000453:epidemiology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose
keywords: Epidemiology; atherosclerosis; carotid ultrasound; coronary artery calcium; type 2 diabetes