Cardiovascular Risk Profile in Subjects With Prediabetes and New-Onset Type 2 Diabetes Identified by HbA1c According to American Diabetes Association Criteria.

OBJECTIVE We investigated the cardiovascular risk pro le in subjects with prediabetes and new-onset type 2 diabetes identified by glycated hemoglobin A_1c (HbA_1c) according to the new American Diabetes Association criteria. RESEARCH DESIGN AND METHODS Arterial stiffness, intima-media thickness (IMT), soluble receptor for advanced glycation end products (sRAGEs), and oral glucose tolerance test (OGTT) were evaluated in 274 subjects without a previous history of diabetes. The subjects were stratified into three groups according to the HbA_1c levels. RESULTS The subjects with prediabetes (n = 117, HbA_1c 5.7-6.4% [39-46 mmol/mol]) showed a higher augmentation (Aug), augmentation index (Augl), and IMT compared with those with lower HbA_1c; however, these values were similar to those of subjects with HbA_1c >6.5%(48mmol/mol). When we further analyzed the subjects with prediabetes but included only subjects with normal glucose tolerance (NT) in the analysis, Augl and IMT still remained significantly higher than their levels in control subjects with HbA_1c <5.7% (39 mmol/mol). After multiple regression analyses including several cardiovascular risk factors, only HbA_1c, age, and sRAGE were significantly correlated with the IMT, whereas age and 1-h postload glucose were the major determinants of Augl. CONCLUSIONS Our data show that subjects with prediabetes according to HbA_1c, but with both NT according to the OGTT and normal fasting glycemia, have an altered IMT and Augl. These data suggest that a simple, reproducible, and less expensive marker such as HbA_1c may be better able to identify prediabetic subjects at high cardiovascular risk compared with fasting glycemia or OGTT alone. [ABSTRACT FROM AUTHOR]