Research Article| Volume 212, ISSUE 1, P316-320, September 2010

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Occult impaired glucose regulation in patients with atherosclerosis is associated to the number of affected vascular districts and inflammation



      The role of inflammatory adipokines has clear mechanistic effects in the promotion of both DM2 and cardiovascular diseases (CVDs), but it is unknown to what extent atherosclerosis-related inflammation might promote defects of glucose metabolism. The purpose of this study was to test the hypothesis that in subjects with atherosclerotic vascular disease and no previous medical record of type 2 diabetes mellitus (DM2), the diagnosis of occult impaired glucose regulation (IGR) is related to the severity of atherosclerosis, measured as the single or combined presence of an history of coronary artery disease (CAD), carotid atherosclerosis (Car-ATS) and peripheral artery disease (PAD).


      In a population of 551 subjects (440 men and 111 women) with a previous history of atherosclerosis, we investigated the presence of IGR (including both impaired glucose tolerance and DM2). To test the correlation between conventional and non-conventional risk factors for cardiovascular disease and diabetes we used logistic and regression analysis models.


      IGR was more prevalent in patients with a documented vascular disease in two or three vessel districts compared with patients with only one symptomatic district (p = 0.016). Among classic risk factors we found that waist circumference was correlated neither to IGR nor to symptomatic vascular disease extension. By contrast, adiponectin level was independently associated to vascular and glucose regulation status (p = 0.012 and p < 0.001, respectively).


      In subjects affected by atherosclerotic vascular diseases, the presence of impaired glucose regulation is associated to the number of vascular districts affected and to a reduced adiponectin level.


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        • Beckman J.A.
        • Creager M.A.
        • Libby P.
        Diabetes and atherosclerosis: epidemiology, pathophysiology, and management.
        JAMA. 2002; 287: 2570-2581
        • Creager M.A.
        • Lüscher T.F.
        • Cosentino F.
        • et al.
        Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part I.
        Circulation. 2003; 108: 1527-1532
        • Lüscher T.F.
        • Creager M.A.
        • Beckman J.A.
        • et al.
        Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part II.
        Circulation. 2003; 108: 1655-1661
        • Stern M.P.
        Do non-insulin-dependent diabetes mellitus and cardiovascular disease share common antecedents?.
        Ann Intern Med. 1996; 124: 110-116
        • Hanley A.J.
        • Festa A.
        • D’Agostino Jr., R.B.
        • et al.
        Metabolic and inflammation variable clusters and prediction of type 2 diabetes: factor analysis using directly measured insulin sensitivity.
        Diabetes. 2004; 53: 1773-1781
        • Lorenzo C.
        • Okoloise M.
        • Williams K.
        • et al.
        The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study.
        Diabetes Care. 2003; 26: 3153-3159
        • Sattar N.
        • Gaw A.
        • Scherbakova O.
        • et al.
        Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study.
        Circulation. 2003; 108: 414-419
        • Duncan B.B.
        • Schmidt M.I.
        • Pankow J.S.
        • et al.
        Atherosclerosis risk in communities study. Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study.
        Diabetes. 2003; 52: 1799-1805
        • D’Agostino Jr., R.B.
        • Hamman R.F.
        • Karter A.J.
        • et al.
        Cardiovascular disease risk factors predict the development of type 2 diabetes: the insulin resistance atherosclerosis study.
        Diabetes Care. 2004; 27: 2234-2240
        • Hu F.B.
        • Stampfer M.J.
        • Haffner S.M.
        • et al.
        Elevated risk of cardiovascular disease prior to clinical diagnosis of type 2 diabetes.
        Diabetes Care. 2002; 25: 1129-1134
        • Meigs J.B.
        • O’donnell C.J.
        • Tofler G.H.
        • et al.
        Hemostatic markers of endothelial dysfunction and risk of incident type 2 diabetes: the Framingham Offspring Study.
        Diabetes. 2006; 55: 530-537
        • Su Y.
        • Liu X.M.
        • Sun Y.M.
        • et al.
        Endothelial dysfunction in impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes mellitus.
        Am J Cardiol. 2008; 102: 497-498
        • Wannamethee S.G.
        • Lowe G.D.
        • Rumley A.
        • et al.
        Adipokines and risk of type 2 diabetes in older men.
        Diabetes Care. 2007; 30: 1200-1205
        • Kumada M.
        • Kihara S.
        • Sumitsuji S.
        • et al.
        Coronary artery disease. Association of hypoadiponectinemia with coronary artery disease in men.
        Arterioscler Thromb Vasc Biol. 2003; 23: 85-89
        • Otsuka F.
        • Sugiyama S.
        • Kojima S.
        • et al.
        Plasma adiponectin levels are associated with coronary lesion complexity in men with coronary artery disease.
        J Am Coll Cardiol. 2006; 48: 1155-1162
        • Pischon T.
        • Girman C.J.
        • Hotamisligil G.S.
        • et al.
        Plasma adiponectin levels and risk of myocardial infarction in men.
        JAMA. 2004; 291: 1730-1737
        • Norhammar A.
        • Tenerz A.
        • Nilsson G.
        • et al.
        Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study.
        Lancet. 2002; 359: 2140-2144
        • Wallander M.
        • Malmberg K.
        • Norhammar A.
        • et al.
        Oral glucose tolerance test: a reliable tool for early detection of glucose abnormalities in patients with acute myocardial infarction in clinical practice: a report on repeated oral glucose tolerance tests from the GAMI study.
        Diabetes Care. 2008; 31: 36-38
        • Bartnik M.
        • Rydén L.
        • Ferrari R.
        • et al.
        The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe. The Euro Heart Survey on diabetes and the heart.
        Eur Heart J. 2004; 25: 1880-1890
        • Rizza S.
        • Clementi F.
        • Porzio O.
        • et al.
        Adiponectin isoforms are not associated with the severity of coronary atherosclerosis but with undiagnosed diabetes in patients affected by stable CAD.
        Nutr Metab Cardiovasc Dis. 2009; 19: 54-60
        • Martuscelli E.
        • Romagnoli A.
        • D’Eliseo A.
        • et al.
        Evaluation of venous and arterial conduit patency by 16-slice spiral computed tomography.
        Circulation. 2004; 110: 3234-3238
        • Grant E.G.
        • Benson C.B.
        • Moneta G.L.
        • et al.
        Radiology. 2003; 229: 340-346
        • de Vries M.
        • Ouwendijk R.
        • Flobbe K.
        • et al.
        Peripheral arterial disease: clinical and cost comparisons between Duplex US and contrast-enhanced MR angiography—a multicenter Randomized Trial.
        Radiology. 2006; 240: 401-410
        • Pischon T.
        • Hu F.B.
        • Rexrode K.M.
        • et al.
        Inflammation, the metabolic syndrome, and risk of coronary heart disease in women and men.
        Atherosclerosis. 2008; 197: 392-399
        • Pai J.K.
        • Pischon T.
        • Ma J.
        • et al.
        Inflammatory markers and the risk of coronary heart disease in men and women.
        N Engl J Med. 2004; 351: 2599-2610
        • Schulze M.B.
        • Shai I.
        • Rimm E.B.
        • et al.
        Adiponectin and future coronary heart disease events among men with type 2 diabetes.
        Diabetes. 2005; 54: 534-539
        • Schulze M.B.
        • Rimm E.B.
        • Shai I.
        • et al.
        Relationship between adiponectin and glycemic control, blood lipids, and inflammatory markers in men with type 2 diabetes.
        Diabetes Care. 2004; 27: 1680-1687
        • Meigs J.B.
        • Hu F.B.
        • Rifai N.
        • et al.
        Biomarkers of endothelial dysfunction and risk of type 2 diabetes mellitus.
        JAMA. 2004; 291: 1978-1986
        • Maeda N.
        • Shimomura I.
        • Kishida K.
        • et al.
        Diet-induced insulin resistance in mice lacking adiponectin/ACRP30.
        Nat Med. 2002; 8: 731-737
        • Wang B.
        • Jenkins J.R.
        • Trayhurn P.
        Expression and secretion of inflammation-related adipokines by human adipocytes differentiated in culture: integrated response to TNF-alpha.
        Am J Physiol Endocrinol Metab. 2005; 288: E731-E740