title: One-hour post-load hyperglycemia combined with HbA1c identifies pre-diabetic individuals with a higher cardio-metabolic risk burden.
abstract: Evidence suggests that combining 1-hour plasma glucose ≥155 mg/dl during an oral glucose tolerance test (OGTT) with glycosylated hemoglobin (HbA1c) significantly increases their predictive power for incident diabetes, while their individual and joint associations with cardio-metabolic risk factors remain undefined. Herein, we evaluated whether 1-hour post-load plasma glucose ≥155 mg/dl combined with HbA1c may identify pre-diabetic individuals with a higher cardio-metabolic risk.
  
  
  
  Anthropometric and metabolic characteristics, insulin sensitivity and insulin secretion assessed by OGTT-derived indexes, carotid intima-media thickness (IMT), pulse pressure, and rate pressure product were evaluated in 1495 individuals.
  
  
  
  As compared with subjects with 1-hour post-load glucose <155 mg/dl, individuals with 1-hour post-load glucose ≥155 mg/dl exhibited a significantly worse cardio metabolic profile, both in the group with HbA1c <5.7%, and in the group with prediabetes (HbA1c 5.7-6.4%). Specifically, in both groups, subjects with 1-hour post-load glucose ≥155 mg/dl had higher fasting and 2-h post-load glucose (p < 0.0001 for all in both groups), higher HOMA-IR (p < 0.0001 in both groups), and carotid IMT (p = 0.05 in the group with HbA1c <5.7% and p = 0.03 in the group HbA1c 5.7-6.4%), as well as lower Matsuda index, insulinogenic index and disposition index (p < 0.0001 in both groups), and lower insulin-stimulated glucose disposal (p < 0.0001 in the group with HbA1c <5.7% and p = 0.03 in the group HbA1c 5.7-6.4%).
  
  
  
  Hyperglycemia at 1-hour during an OGTT may be a useful tool to identify a subset of individuals within HbA1c-defined glycemic categories at higher risk of developing type 2 diabetes and cardiovascular disease.
authors: Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors: Teresa Vanessa
authors: TV
authors: Fiorentino
authors: Catholic University, Rome, Italy.
authors: Franz
authors: F
authors: Sesti
authors: Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors: Francesco
authors: F
authors: Andreozzi
authors: Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors: Elisabetta
authors: E
authors: Pedace
authors: Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors: Angela
authors: A
authors: Sciacqua
authors: Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy; Catholic University, Rome, Italy.
authors: Marta Letizia
authors: ML
authors: Hribal
authors: Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors: Francesco
authors: F
authors: Perticone
authors: Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy. Electronic address: sesti@unicz.it.
authors: Giorgio
authors: G
authors: Sesti
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood*; D015994:Incidence; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011236:Prediabetic State / Q000097:blood* / Q000175:diagnosis*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: 1h-post load hyperglycemia; Arterial stiffness; Carotid IMT; Insulin secretion; Insulin sensitivity; Myocardial workload; Prediabetes