Cardiovascular risk profiles in the prediabetes state:Tehran Lipid and Glucose Study (TLGS)

Because of the importance of the prediabetes state in increasing non-communicable diseases, evaluation and comparison of IFG and IGT, in terms of the non-communicable risk factors of these two conditions, can be of great help in the identification of metabolic characteristics. 4944 individuals, 30-60 yrs, were selected randomly from the TLGS population and after matching for age and sex, exclusion of known diabetics, and following ingestion of 75 gr glucose were divided into 5 groups based on FBS and OGTT isolated IFG (110 mg/dL ≤ FBS<126 mg/dL, n=79), isolated IGT (140≤ 2hpp < 200,n=435), IGT/IFG (having both IGT and IFG, n=73), new diabetes (2hpp ≥ 200 or FBS ≥ 126,n = 205) and normal (neither IFG nor IGT, n=750). Blood pressure, BMI, WHR and serum lipids were measured in all groups. Hypertension, anthropometric data (general and abdominal obesity) and high risk dyslipidemia were defined according to JNC VI,WHO and ATP III criteria respectively. We compared the mean values and prevalence of risk factors among the different groups. In the IGT group, the prevalences of hypertension, general and abdominal obesity and high serum total cholesterol (TC), triglycerides (TG) and LDL-C (38,39,73,37,44 and 32% respectively) were higher than in controls (P<0.001). The IFG group had higher prevalence of hypertension and high serum TG(40 and 35% respectively) vs controls (p=0.004 and 0.03 respectively). In the IFG/IGT group the prevalence of hypertension, general and abdominal obesity and high serum TG (48,50,75 and 48% respectively) were higher than in controls (P<0.001). There was a higher prevalence of general and abdominal obesity in IGT vs IFG (39 vs 28%,P=0.03 and 73 vs 64%,P=0.04 respectively). There was also a higher prevalence of general obesity in the IFG/IGT (50%) vs the IFG (P=0.003) or the IGT groups (P=0.04). No statistically significant difference was seen in the prevalence of high serum TC and LDL-C between the diabetes and IFG or IGT groups. The IFG/IGT group had no difference with the diabetes group in the prevalence of risk factors except high serum TG. The higher prevalence of some of the cardiovascular risk factors in IGT vs IFG could explain the difference in the cardiovascular events in these two groups. Lack of differences in the prevalence and mean values some of the cardiovascular risk factors in the prediabetes state vs overt diabetes calls for more attention to this stage for prevention of cardiovascular diseases.