title: HbA1c increase is associated with higher coronary and peripheral atherosclerotic burden in non diabetic patients.
abstract: Prediabetes is associated with an increased risk of developing diabetes and cardiovascular disease. Our objective was to examine the cardiovascular (CV) risk profile of non-diabetic patients with and without prediabetes according to HbA1c, using macroangiopathic imaging biomarkers.
  
  
  
  Our population consisted of 272 non diabetic patients aged between 40 and 70 years, with a normal fasting plasma glucose (FPG <5.6 mmol/L) and at least 1 CV risk factor. Exclusion criteria were prior history of CV disease or clinical evidence of advanced renal disease. Prediabetes was defined as an HbA1c value of 5.7-6.4%. Coronary artery calcium (CAC) score as well as mean common carotid intima media thickness (IMT) and plaque presence were assessed using consensus criteria.
  
  
  
  CAC score was higher in the prediabetes group compared to non-prediabetic subjects (131.7 ± 295.6 vs. 62.4 ± 178.8 AU, p < 0.001). Prediabetic subjects had higher mean IMT than non-exposed subjects (0.77 ± 0.14 vs. 0.61 ± 0.15 mm, p < 0.001). The proportion of prediabetic patients with CAC = 0 was significantly lower compared to non-exposed subjects (35% vs. 63%, p < 0.01). In contrast, the proportion of patients with a CAC >400 was significantly higher in the prediabetes group (10% vs. 3%, p < 0.05). Moreover, carotid plaques were significantly more present in patients with prediabetes than in the normoglycemic subjects (p < 0.01). In a multiple linear regression, IMT was associated with HbA1c continuous levels (p < 0.001). In addition, logistic regression showed that higher HbA1c levels were associated with CAC and carotid plaques presence (p for trend for all < 0.001).
  
  
  
  Among patients with normal fasting glucose, HbA1c increase is associated with higher coronary and peripheral atherosclerotic burden in non-diabetic patients.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Cardiovascular Prevention Unit and Endocrinology Service, Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group, Pierre et Marie Curie University, Paris, France.
authors.forename: Roberto
authors.initials: R
authors.lastname: Scicali
authors.affiliation: Cardiovascular Prevention Unit and Endocrinology Service, Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group, Pierre et Marie Curie University, Paris, France; Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM), Pierre et Marie Curie University (UPMC - Paris VI), Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Giral
authors.affiliation: Cardiovascular Prevention Unit and Endocrinology Service, Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group, Pierre et Marie Curie University, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'imagerie Biomédicale, Paris, France.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gallo
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Di Pino
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Agata Maria
authors.initials: AM
authors.lastname: Rabuazzo
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Purrello
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'imagerie Biomédicale, Paris, France; Département d'imagerie cardiovasculaire et de radiologie interventionnelle, Pôle Imagerie-Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Cluzel
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'imagerie Biomédicale, Paris, France; Département d'imagerie cardiovasculaire et de radiologie interventionnelle, Pôle Imagerie-Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Alban
authors.initials: A
authors.lastname: Redheuil
authors.affiliation: Cardiovascular Prevention Unit and Endocrinology Service, Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group, Pierre et Marie Curie University, Paris, France; Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM), Pierre et Marie Curie University (UPMC - Paris VI), Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Bruckert
authors.affiliation: Cardiovascular Prevention Unit and Endocrinology Service, Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group, Pierre et Marie Curie University, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'imagerie Biomédicale, Paris, France. Electronic address: david.rosenbaum@aphp.fr.
authors.forename: David
authors.initials: D
authors.lastname: Rosenbaum
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; 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 / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D011236:Prediabetic State / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D015854:Up-Regulation; D061205:Vascular Calcification / Q000175:diagnosis / Q000209:etiology*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Cardiovascular risk assessment; Coronary artery calcium; HbA1c; Intima media thickness; Prediabetes