Prediabetes diagnosis is associated with the progression of coronary artery calcification: The Kangbuk Samsung Health Study
Yoosoo Chang and Seungho Ryu contributed equally to this work as corresponding authors.
Funding information: Southampton NIHR Biomedical Research Centre, Grant/Award Number: IS-BRC-20004; SKKU Excellence in Research Award Research Fund, Sungkyunkwan University, 2020
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.
CONFLICT OF INTEREST
The authors have no conflicts of interest to disclose.
Open Research
PEER REVIEW
The peer review history for this article is available at https://publons.com/publon/10.1111/dom.14797.
DATA AVAILABILITY STATEMENT
The data are not available to be shared publicly, because we do not have permission from the Institutional Review Board to distribute the data. However, data are available from the Kangbuk Samsung Health Study upon request, whose authors may be contacted through the corresponding authors for this manuscript.
