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Prediabetes diagnosis is associated with the progression of coronary artery calcification: the Kangbuk Samsung Health Study

Prediabetes diagnosis is associated with the progression of coronary artery calcification: the Kangbuk Samsung Health Study
Prediabetes diagnosis is associated with the progression of coronary artery calcification: the Kangbuk Samsung Health Study

Aim: To investigate the associations between prediabetes defined by different diagnostic criteria and coronary artery calcification (CAC) and its progression over time. Materials and Methods: This cross-sectional study included 146 436 Korean adults without diabetes who underwent CAC estimation computed tomography (CT) during health examinations from 2011 to 2019. We used multinomial logistic regression models. The longitudinal study comprised 41 100 participants with at least one follow-up cardiac CT and annual CAC progression rates and ratios were estimated. Prediabetes was categorized into three groups: isolated glucose prediabetes (fasting blood glucose [FBG] 100-125 mg/dl, HbA1c < 5.7%), isolated HbA1c prediabetes (FBG < 100 mg/dl, HbA1c 5.7%-6.4%) and prediabetes meeting both FBG and HbA1c criteria (FBG 100-125 mg/dl, HbA1c 5.7%-6.4%). Results: After adjusting for covariates, the prevalence ratios (95% CI) for CAC scores of more than 100 comparing isolated glucose prediabetes, isolated HbA1c prediabetes and prediabetes fulfilling both criteria with those of normoglycaemia were 1.12 (0.99-1.26), 1.24 (1.11-1.39) and 1.31 (1.18-1.45), respectively. The multivariable-adjusted ratio (CIs) of annual CAC progression rates comparing the corresponding groups with the normoglycaemia group were 1.031 (1.023-1.039), 1.025 (1.019-1.032) and 1.054 (1.047-1.062), respectively. Conclusions: CAC risk and CAC progression were consistently highest in individuals meeting both glucose and HbA1c criteria, while all three prediabetes types showed a significantly increased risk of CAC progression. Atherosclerosis risk reduction management is necessary for prediabetes, especially in patients meeting both criteria.

HbA1c, coronary artery calcification, fasting plasma glucose, prediabetes, subclinical atherosclerosis
1462-8902
2118-2126
Choi, In Young
7350e48f-9d33-45ce-8d3a-4fd3d567ad40
Chang, Yoosoo
dba660a2-b01e-4960-b746-7a9f174ce2ab
Cho, Yoosun
9b1fdb04-0b50-4610-a126-3be380f5354a
Kang, Jeonggyu
70762e4d-cdf8-48ab-9e27-b965b5b9d908
Jung, Hyun-Suk
b962be30-c336-440a-b45a-f246f9a72c04
Wild, Sarah H.
43ef52e4-48f3-4fe4-8f07-dfa8f5aada19
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
fa3d8fbb-7052-4ff6-b84a-a1cddf8d50a0
Choi, In Young
7350e48f-9d33-45ce-8d3a-4fd3d567ad40
Chang, Yoosoo
dba660a2-b01e-4960-b746-7a9f174ce2ab
Cho, Yoosun
9b1fdb04-0b50-4610-a126-3be380f5354a
Kang, Jeonggyu
70762e4d-cdf8-48ab-9e27-b965b5b9d908
Jung, Hyun-Suk
b962be30-c336-440a-b45a-f246f9a72c04
Wild, Sarah H.
43ef52e4-48f3-4fe4-8f07-dfa8f5aada19
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
fa3d8fbb-7052-4ff6-b84a-a1cddf8d50a0

Choi, In Young, Chang, Yoosoo, Cho, Yoosun, Kang, Jeonggyu, Jung, Hyun-Suk, Wild, Sarah H., Byrne, Christopher and Ryu, Seungho (2022) Prediabetes diagnosis is associated with the progression of coronary artery calcification: the Kangbuk Samsung Health Study. Diabetes, Obesity and Metabolism, 24 (11), 2118-2126. (doi:10.1111/dom.14797).

Record type: Article

Abstract

Aim: To investigate the associations between prediabetes defined by different diagnostic criteria and coronary artery calcification (CAC) and its progression over time. Materials and Methods: This cross-sectional study included 146 436 Korean adults without diabetes who underwent CAC estimation computed tomography (CT) during health examinations from 2011 to 2019. We used multinomial logistic regression models. The longitudinal study comprised 41 100 participants with at least one follow-up cardiac CT and annual CAC progression rates and ratios were estimated. Prediabetes was categorized into three groups: isolated glucose prediabetes (fasting blood glucose [FBG] 100-125 mg/dl, HbA1c < 5.7%), isolated HbA1c prediabetes (FBG < 100 mg/dl, HbA1c 5.7%-6.4%) and prediabetes meeting both FBG and HbA1c criteria (FBG 100-125 mg/dl, HbA1c 5.7%-6.4%). Results: After adjusting for covariates, the prevalence ratios (95% CI) for CAC scores of more than 100 comparing isolated glucose prediabetes, isolated HbA1c prediabetes and prediabetes fulfilling both criteria with those of normoglycaemia were 1.12 (0.99-1.26), 1.24 (1.11-1.39) and 1.31 (1.18-1.45), respectively. The multivariable-adjusted ratio (CIs) of annual CAC progression rates comparing the corresponding groups with the normoglycaemia group were 1.031 (1.023-1.039), 1.025 (1.019-1.032) and 1.054 (1.047-1.062), respectively. Conclusions: CAC risk and CAC progression were consistently highest in individuals meeting both glucose and HbA1c criteria, while all three prediabetes types showed a significantly increased risk of CAC progression. Atherosclerosis risk reduction management is necessary for prediabetes, especially in patients meeting both criteria.

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More information

Accepted/In Press date: 6 June 2022
e-pub ahead of print date: 13 June 2022
Published date: November 2022
Additional Information: Funding Information: Southampton NIHR Biomedical Research Centre, Grant/Award Number: IS‐BRC‐20004; SKKU Excellence in Research Award Research Fund, Sungkyunkwan University, 2020 Funding information Funding Information: This study was supported by the Sungkyunkwan University Excellence in Research Award Research Fund, Sungkyunkwan University, 2020. CDB is supported in part by the Southampton NIHR Biomedical Research Centre, UK (IS‐BRC‐20004). Publisher Copyright: © 2022 John Wiley & Sons Ltd.
Keywords: HbA1c, coronary artery calcification, fasting plasma glucose, prediabetes, subclinical atherosclerosis

Identifiers

Local EPrints ID: 458037
URI: http://eprints.soton.ac.uk/id/eprint/458037
ISSN: 1462-8902
PURE UUID: a89dcc25-62f6-4116-807c-510c5a66a5e8
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

Catalogue record

Date deposited: 27 Jun 2022 16:57
Last modified: 08 Feb 2023 17:32

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Contributors

Author: In Young Choi
Author: Yoosoo Chang
Author: Yoosun Cho
Author: Jeonggyu Kang
Author: Hyun-Suk Jung
Author: Sarah H. Wild
Author: Seungho Ryu

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