Fasting glucose levels, incident diabetes, subclinical atherosclerosis and cardiovascular events in apparently healthy adults: A 12-year longitudinal study

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Abstract

We aimed to study the association between fasting plasma glucose, diabetes incidence and cardiovascular burden after 10–12 years. We evaluated diabetes and cardiovascular events incidences, carotid intima-media thickness and coronary artery calcium scores in ELSA-Brasil (the Brazilian Longitudinal Study of Adult Health) baseline (2008–2010) of 1536 adults without diabetes in 1998. We used regression models to estimate association with carotid intima-media thickness (in mm), coronary artery calcium scores (in Agatston points) and cardiovascular events according to fasting plasma glucose in 1998. Adjusted diabetes incidence rate was 9.8/1000 person-years (95% confidence interval: 7.7–13.6/1000 person-years). Incident diabetes was positively associated with higher fasting plasma glucose. Fasting plasma glucose levels 110–125 mg/dL were associated with higher carotid intima-media thickness (β = 0.028; 95% confidence interval: 0.003–0.053). Excluding those with incident diabetes, there was a borderline association between higher carotid intima-media thickness and fasting plasma glucose 110–125 mg/dL (β = 0.030; 95% confidence interval: −0.005 to 0.065). Incident diabetes was associated with higher carotid intima-media thickness (β = 0.034; 95% confidence interval: 0.015–0.053), coronary artery calcium scores ≥400 (odds ratio = 2.84; 95% confidence interval: 1.17–6.91) and the combined outcome of a coronary artery calcium scores ≥400 or incident cardiovascular event (odds ratio = 3.50; 95% confidence interval: 1.60–7.65). In conclusion, fasting plasma glucose in 1998 and incident diabetes were associated with higher cardiovascular burden.

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