title: Cardio-metabolic profile of subjects with early stages of glucose intolerance and cardiovascular autonomic dysfunction.
abstract: OBJECTIVE
  The present study evaluates the cardio-metabolic profile of subjects with early stages of glucose intolerance and presence of cardiovascular autonomic dysfunction (CAD).
  
  
  METHODS
  478 subjects, of mean age 49.3±13.7years and mean BMI 31.0±6.2kg/m2, divided according to glucose tolerance: 130 with normal glucose tolerance, 227 with prediabetes, and 121 with newly-diagnosed type 2 diabetes, were enrolled. Glucose tolerance was studied during OGTT applying 2006 WHO criteria. Anthropometric indices, blood pressure, HbA1c, serum lipids, hsCRP, and albumin-to-creatinine ratio (ACR) were measured. Body fat distribution was estimated by a bioimpedance method (InBody720, BioSpace). Tissue AGEs accumulation was assessed by skin autofluorescence (AGE-Reader-DiagnOptics™). CAD was assessed by ANX-3.0 method.
  
  
  RESULTS
  CAD was found in 24.1% of subjects with any disorder of glucose tolerance in comparison to 12.3% in NGT, OR 2.0 (95% CI: 1.2-3.2), p=0.005. Sympathetic and parasympathetic tone declined with the progression of glucose intolerance. Age, waist circumference, visceral fat area, fasting and 120-min plasma glucose, HbA1c, AGEs, ACR and QTc interval were higher in subjects with CAD, p<0.05. In a logistic regression analysis the panel of age >53years (76% sensitivity, 61% specificity), HbA1c >6.0% (66% sensitivity, 60% specificity), QTc interval >423ms (65% sensitivity, 61% specificity) and presence of arterial hypertension (83% sensitivity, 55% specificity) was related to the presence of CAD - AUC 0.778 (95% CI: 0.73-0.83), p<0.001.
  
  
  CONCLUSIONS
  Our results demonstrate a high prevalence of CAD in early stages of glucose dysmetabolism. Age, HbA1c, QTc interval and presence of arterial hypertension are related to the presence of CAD in this population.
authors.affiliation: Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia 1431, Bulgaria. Electronic address: dr.roumyana.dimova@gmail.com.
authors.forename: Rumyana
authors.initials: R
authors.lastname: Dimova
authors.affiliation: Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia 1431, Bulgaria.
authors.forename: Tsvetalina
authors.initials: T
authors.lastname: Tankova
authors.affiliation: Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia 1431, Bulgaria.
authors.forename: Nevena
authors.initials: N
authors.lastname: Chakarova
authors.affiliation: Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia 1431, Bulgaria.
authors.forename: Greta
authors.initials: G
authors.lastname: Grozeva
authors.affiliation: Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia 1431, Bulgaria.
authors.forename: Lilia
authors.initials: L
authors.lastname: Dakovska
mesh_terms: D000328:Adult; D000886:Anthropometry; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000453:epidemiology*; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D005260:Female; D018149:Glucose Intolerance / Q000150:complications*; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D055442:Metabolome; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood; D015995:Prevalence
chemical_list: D001786:Blood Glucose
keywords: Cardio-vascular autonomic dysfunction; Early stages of glucose intolerance