Quarterly Focus Issue: Prevention/Outcome
Clinical Research: Cardiovascular Risk
Pre-Diabetes and the Risk for Cardiovascular Disease: A Systematic Review of the Evidence

https://doi.org/10.1016/j.jacc.2009.10.060Get rights and content
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Objectives

Our objective was to estimate the magnitude of the relative risk (RR) for cardiovascular disease associated with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) from published prospective observational studies.

Background

Hyperglycemia is a known risk factor for cardiovascular disease. However, the magnitude of the RR for cardiovascular disease associated with IFG and IGT is unclear.

Methods

We searched PubMed from 1997 through 2008 for relevant publications and performed a meta-analysis.

Results

In 18 publications with information about IFG (110 to 125 mg/dl) (IFG 110), estimates of RR ranged from 0.65 to 2.50. The fixed-effects summary estimate of RR was 1.20 (95% confidence interval [CI]: 1.12 to 1.28). In 8 publications with information about IFG (100 to 125 mg/dl) (IFG 100), estimates of RR ranged from 0.87 to 1.40. The fixed-effects summary estimate of RR was 1.18 (95% CI: 1.09 to 1.28). In 8 publications with information about IGT, estimates of RR ranged from 0.83 to 1.34. The fixed-effects summary estimate of RR was 1.20 (95% CI: 1.07 to 1.34). Five studies combined IFG and IGT, yielding a fixed-effects summary estimate of RR of 1.10 (95% CI: 0.99 to 1.23). No significant difference between the summary estimates for men and women were detected (IFG 110: men: 1.17 [95% CI: 1.05 to 1.31], women: 1.30 [95% CI: 1.10 to 1.54]; IFG 100: men: 1.23 [95% CI: 1.06 to 1.42], women: 1.16 [95% CI: 0.99 to 1.36]).

Conclusions

Impaired fasting glucose and IGT are associated with modest increases in the risk for cardiovascular disease.

Key Words

cardiovascular diseases
coronary heart disease
hyperglycemia
meta-analysis
prediabetic state
review

Abbreviations and Acronyms

ADA
American Diabetes Association
CI
confidence interval
IFG
impaired fasting glucose
IGT
impaired glucose tolerance
OGTT
oral glucose tolerance test
RR
relative risk
SE
standard error
WHO
World Health Organization

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The findings and conclusions in this article are those of the authors and do not represent the official position of the Centers for Disease Control and Prevention.