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Abstract
Background
Prediabetes is the condition associated with the development of type 2 diabetes and a risk of cardiovascular disease. Abnormal homocysteine levels have been found to be associated with atherosclerosis in diabetes, but not well studied in pre-diabetes. In this study we investigated the relationship between blood homocysteine levels and subclinical atherosclerosis in the individuals with impaired fasting glucose.
Method
Individuals with impaired fasting glucose with fasting blood glucose concentrations of 100-125 mg/dL (1,537 men and 1,563 women) were selected from 10,848 health examinees who underwent an ultrasonographic examination of carotid artery during health check-up over 20 yr. The subjects were divided into 4 quartile groups depending on homocysteine levels. We investigated the association of each homocysteine quartile with abnormal carotid intima-media thickness (CIMT) and carotid plaque by using logistic regression analysis.
Results
Factors associated with abnormal CIMT and carotid plaque were age, homocysteine levels, blood pressure, and fasting blood glucose levels. Logistic regression analysis adjusted for gender and confounding factors showed that the third- and fourth- quartile homocysteine level groups had higher odds ratios ([OR]-95% confidence interval [CI])- for abnormal CIMT (1.656 [1.11-2.47], P=0.013, 1.966 [1.32-2.93], P=0.001, respectively) and for carotid plaque (1.608 [1.01-2.56], P=0.045, 1.913 [1.22-3.00], P=0.005, respectively) than did the first quartile group.
Figures and Tables
Table 1
Characteristics of the subjects according to the fasting glucose level
P value derived from one-way ANOVA and χ2 test used for intergroup comparison.
*P<0.05 derived from posthoc comparisons (Dunnett's test) between the normal group and the IFG I or the IFG II; †P<0.05 derived from the comparison of variables between the IFG I and the IFG II.
Abbreviations: IFG I, impaired fasting glucose group I (100 mg/dL ≤fasting glucose≤109 mg/dL); IFG II, impaired fasting glucose group II (110 mg/dL ≤fasting glucose≤125 mg/dL); BMI, body mass index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; TC, total cholesterol; TG, triglyceride; HDL-C, HDL-cholesterol; LDL-C, LDL-cholesterol; FBS, fasting blood sugar; HbA1c, hemoglobin A1c; Hcy, homocysteine; hsCRP, high sensitivity C-reactive protein; CIMT, carotid intima-media thickness.
Table 2
Characteristics of subjects categorized by presence of abnormal carotid intima-media thickness and carotid plaque in impaired fasting glucose
*P<0.05 were determined by using Student's t test for comparing the normal carotid artery and abnormal carotid intima-media thickness; †P<0.05 were determined by using Student's t test for comparing the normal carotid artery and carotid plaque.
Abbreviations: See Table 1.
Table 3-1
Clinical and laboratory characteristics according to homocysteine quartile group in men with impaired fasting glucose
P value derived from one-way ANOVA and χ2 test used for intergroup comparison.
Abbreviations: Q, quartile. For other abbreviations see Table 1.
Table 3-2
Clinical and laboratory characteristics according to homocysteine quartile group in women with impaired fasting glucose
P value derived from one-way ANOVA and χ2 test used for intergroup comparison.
Abbreviations: Q, quartile. For other abbreviations see Table 1.
Table 4
Logistic regression analysis for the variables affecting abnormal carotid intima-media thickness and carotid plaque in impaired fasting glucose
This model was adjusted for age, sex, body mass index, waist circumference, blood pressure, blood lipid, fasting blood glucose and HbA1c.
Abbreviations: OR, odds ratio; CI, confidence interval. For other abbreviations see Table 1.
Table 5
Multivariate logistic regression analysis for the effect of homocysteine quartile on abnormal carotid intima-media thickness and carotid plaque in impaired fasting glucose
This model was adjusted for age, sex, blood pressure, fasting blood glucose and HbA1c.
Abbreviations: OR, odds ratio; CI, confidence interval. For other abbreviations see Table 1.
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