title: Association between markers of glycemia and carotid intima-media thickness: the MARK study.
abstract: Carotid intima-media thickness (C-IMT) is a reliable predictor of cardiovascular events. We Investigated the relationship between markers of glycemia and C-IMT in intermediate-risk cardiovascular patients.
  
  
  
  This study analyzed 427 subjects, aged 35 to 74 years (mean, 60.3 ± 8.5 years), 55 % women, enrolled into the MARK study. Including 231 subjects defined as normal glucose, 104 subjects classified as prediabetes and 92 with type 2 diabetes mellitus. Carotid ultrasound was used to measure C-IMT and the presence of plaques. Fasting plasma glucose (mg/dl) and glycated hemoglobin (%) (HbA1c) were measured using standard enzymatic automated methods. Postprandial glucose (mg/dl) was self-measured by patients at home 2 h after meals (breakfast, lunch and dinner) for 1 day.
  
  
  
  The C-IMT shows a positive correlation with fasting plasma glucose, postprandial glucose and HbA1c. Multiple linear regression analysis showed a positive association between HbA1c and C-IMT, with a 0.016 mm and 0.019 mm increase in mean and maximum C-IMT per 1 % increase in HbA1c. In addition, an association between fasting plasma glucose and C-IMT was found with an increase of 0.004 and 0.005 mm in mean and maximum C-IMT per 10 mg/dl in fasting plasma glucose. We also observed a graded association between fasting plasma glucose, postprandial glucose and HbA1c and the presence of carotid target organ damage (TOD), with an odds ratio of 1.013, 1.010 and 1.425, respectively.
  
  
  
  The results of this study suggest that the fasting plasma glucose and HbA1c, but not postprandial glucose, are associated with C-IMT media and maximum. The patients who present with a metabolic glucose alteration have more risk of developing carotid TOD.
  
  
  
  ClinicalTrials.gov; Identifier: NCT01428934 .
authors: Primary Care Research Unit, the Alamedilla Health Center, 37003, Salamanca, Spain. magomez@usal.es.|Castilla and León Health Service-SACYL, REDIAPP. IBSAL, Salamanca, Spain. magomez@usal.es.|Medicine Department, University of Salamanca, Salamanca, Spain. magomez@usal.es.
authors: Manuel A
authors: MA
authors: Gomez-Marcos
authors: Primary Care Research Unit, the Alamedilla Health Center, 37003, Salamanca, Spain.
authors: Leticia
authors: L
authors: Gomez-Sanchez
authors: Primary Care Research Unit, the Alamedilla Health Center, 37003, Salamanca, Spain.|Statistics Department, University of Salamanca, Salamanca, Spain.
authors: Maria C
authors: MC
authors: Patino-Alonso
authors: Primary Care Research Unit, the Alamedilla Health Center, 37003, Salamanca, Spain.|Castilla and León Health Service-SACYL, REDIAPP. IBSAL, Salamanca, Spain.
authors: Jose I
authors: JI
authors: Recio-Rodriguez
authors: CS San Agustín, Primare Care Ibsalut, Palma of Mallorca, Spain.
authors: Natividad Garcia
authors: NG
authors: Regalado
authors: Research Unit, Family Medicine, Girona, Spain.|Jordi Gol Institute for Primary Care, Research (IDIAP Jordi Gol), Girona, Spain.|Translab Research Group. Department of Medical Sciences, School of Medicine, University of Girona, Girona, Spain.|Girona Biomedical Research Institute (IDIBGI), Dr. Trueta University Hospital, Catalonia, Spain.
authors: Rafel
authors: R
authors: Ramos
authors: Research Unit, Family Medicine, Girona, Spain.|Jordi Gol Institute for Primary Care, Research (IDIAP Jordi Gol), Girona, Spain.|Girona Biomedical Research Institute (IDIBGI), Dr. Trueta University Hospital, Catalonia, Spain.
authors: Ruth
authors: R
authors: Marti
authors: Primary Care Research Unit, the Alamedilla Health Center, 37003, Salamanca, Spain.|Castilla and León Health Service-SACYL, REDIAPP. IBSAL, Salamanca, Spain.
authors: Cristina
authors: C
authors: Agudo-Conde
authors: Primary Care Research Unit, the Alamedilla Health Center, 37003, Salamanca, Spain.|Castilla and León Health Service-SACYL, REDIAPP. IBSAL, Salamanca, Spain.|Medicine Department, University of Salamanca, Salamanca, Spain.
authors: Emiliano
authors: E
authors: Rodriguez-Sanchez
authors: Primary Care Research Unit, the Alamedilla Health Center, 37003, Salamanca, Spain.|Castilla and León Health Service-SACYL, REDIAPP. IBSAL, Salamanca, Spain.
authors: Jose A
authors: JA
authors: Maderuelo-Fernandez
authors: Primary Care Research Unit, the Alamedilla Health Center, 37003, Salamanca, Spain.|Castilla and León Health Service-SACYL, REDIAPP. IBSAL, Salamanca, Spain.|Medicine Department, University of Salamanca, Salamanca, Spain.
authors: Luis
authors: L
authors: Garcia-Ortiz
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D002339:Carotid Arteries; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Fasting plasma glucose; Glycosylated hemoglobin; Intima-media thickness; Postprandial glucose