title: A Glycemic Threshold of 90 mg/dl Promotes Early Signs of Atherosclerosis in Apparetly Healthy Overweight/Obese Subjects.
abstract: BACKGROUND
  Alterations of glucose metabolism represent well known risk factors for the atherosclerotic process and then for cardiovascular disease.
  
  
  OBJECTIVE
  To investigate the association between fasting glucose and early signs of atherosclerosis, by means of carotid intima-media thickness (c-IMT) in a population of apparently healthy overweight/obese subjects. In addition, we evaluated the possible existence of a glycemic threshold above which the risk of atherosclerosis significantly increases.
  
  
  METHODS
  179 overweight/obese (mean BMI: 32 ± 5 kg/m2) subjects, 44 men, aged 40 ± 12.4 years, were enrolled in the study. Blood glucose, insulin, total cholesterol, high and low density lipoprotein cholesterol and triglycerides were detected in all subjects. The Homeostasis Model Assessment of insulin resistance index (HOMA-IR) was also obtained. All subjects underwent carotid echo color Doppler ultrasound to identify c-IMT.
  
  
  RESULTS
  In our population of obese/overweight subjects with insulin resistance (HOMA-IR=3.4 ± 2), c- IMT was positively related to male gender (r = 0.23, P<0.01), age (r = 0.53, P<0.001), waist circumference (r = 0.15, P=0.04), systolic and diastolic blood pressure (r=0.27, P<0.001 and r=0.24, P<0.001 respectively), fasting glucose (r=0.29, P<0.001), triglycerides (r= 0.16 P=0.03), total and low density lipoprotein cholesterol levels (r=0.25 P<0.001 and r=0.21, P<0.01 respectively). Only male gender and fasting glycemia were associated to c-IMT (P<0.01 and P< 0.001, respectively) at multiple regression analysis.
  
  
  CONCLUSIONS
  Blood glucose represented an independent predictor of atherosclerosis in our study population. Moreover, this seemed to be able to favor c-IMT progression for values greater than 90 mg/dl.
authors.forename: Marco Matteo
authors.initials: MM
authors.lastname: Ciccone
authors.affiliation: Cardiovascular disease Section, Department of Organ and Trasplantation, University of Bari, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cortese
authors.forename: Michele
authors.initials: M
authors.lastname: Gesualdo
authors.forename: Ilaria
authors.initials: I
authors.lastname: Donvito
authors.forename: Santa
authors.initials: S
authors.lastname: Carbonara
authors.forename: Giovanni
authors.initials: G
authors.lastname: De Pergola
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D001786:Blood Glucose / Q000378:metabolism / Q000502:physiology*; D004198:Disease Susceptibility; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067329:Obesity, Metabolically Benign / Q000097:blood* / Q000150:complications*; D050177:Overweight / Q000097:blood* / Q000150:complications*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose
keywords: Atherosclerosis; carotid intima-media thickness; glucose; obesity; overweight.