Predicting Cardiovascular Risk In Prediabetes Status: The Role Of Atherogenic Plasma Index In Individuals With Impaired Fasting Glucose

Öz

Atherogenic plasma index (API) is a relatively new index used in the general population for predicting the risk of cardiovascular disease. High fasting plasma glucose (FPG) levels have been shown to be associated with diabetes mellitus and metabolic syndrome, and API. However, no study has been conducted on the relationship between impaired fasting glucose identified using fasting and 2-hour plasma glucose in the oral glucose tolerance test, hemoglobin A1c (HbA1c) levels, and API. API was calculated using the logarithm of the molar ratio of triglycerides to high-density lipoprotein cholesterol. The relationship between glucose metabolism parameters with diabetes status and API was analyzed. The frequency of prediabetes and diabetes in the study participants was 35.3% (n=58) and 25.3% (n=40), respectively. 40 individuals were identified as Type 2 diabetes (fasting glucose >125 mg/dl, OGTT 2nd hour >200 mg/dl), 58 as impaired fasting glucose (IFG) prediabetes (fasting glucose: 100-125 mg/dl, OGTT 2nd hour <140mg/dl), and 66 individuals as a non-diabetic control group (glucose <100 mg/dL). 28.1% of participants were in the low-risk group (API<0.11), 18.2% were in the medium-risk group (API 0.11-0.21), and 53.6% were in the high-risk group (API>0.21). High API (high-risk group) was found to be significantly associated with prediabetes and diabetes status. API was also significantly associated with HbA1c, FPG, and 2-hour plasma glucose levels in the OGTT. AIP was significantly associated with the param¬eters of diabetes and prediabetes. Simple calculations made from fasting lipid panel results can be provide more information in assessing the risk of cardiovascular disease with IFG patients in prediabetes status.

Anahtar Kelimeler

• Atherogenic plasma index
• Prediabetes
• Diabetes mellitus
• Dyslipidemia

Prediyabet Durumunda Kardiyovasküler Riskin Öngörülmesi: Bozulmuş Açlık Glukozu Olan Bireylerde Aterojenik Plazma İndeksinin Rolü

Öz

Aterojenik plazma indeksi (API), kardiyovasküler hastalık riskini tahmin etmek için kullanılan nispeten yeni bir indekstir. API’nin metabolik sendrom, yüksek açlık plazma glukoz (FPG) ve diabetes mellitus ile ilişkili olduğu gösterilmiştir. Bununla birlikte, açlık plazma glukozu oral glukoz tolerans testi (OGTT) 2. saat plazma glukozu ve hemoglobin A1c (HbA1c) kombinasyon testleri kullanılarak API ile bozulmuş açlık glukozu arasındaki ilişkiyi araştıran bir çalışma yapılmamıştır. API, trigliseritin yüksek yoğunluklu lipoprotein kolesterole molar oranının logaritmasını içeren formül kullanılarak hesaplandı. Glikoz metabolizması parametreleri ve saptanan diyabet durumları ile API arasındaki ilişki analiz edildi.: Çalışma katılımcıları arasında prediyabet ve diyabet sıklığı sırasıyla %35,3 (n=58) ve %25,3 (n=40) idi. Katılımcıların %28,1’i düşük risk grubunda (API<0,11), %18,2’si orta risk grubunda (API 0,11-0,21) ve %53,6’sı yüksek risk grubunda (API>0,21) idi. Yüksek AIP (yüksek risk grubu), prediyabet ve diyabet ile önemli ölçüde ilişkiliydi. HbA1c, FPG ve OGTT 2.saat plazma glukoz seviyeleri ile API önemli ölçüde ilişkiliydi. AIP, bozulmuş açlık glukozu ve metabolik sendrom parametreleri ile önemli ölçüde ilişkiliydi. API gibi lipid panelli basit hesaplamalar, prediyabet ve diyabetli hastalarda kardiyovasküler hastalık riskini değerlendirmek için bilgi sağlayabilir.

Anahtar Kelimeler

• Aterojenik Plazma İndexi
• Prediyabet
• Diabetes mellitus
• Dislipidem

Kaynakça

1. 1. Rao Kondapally Seshasai S, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N, et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. The New England journal of medicine 2011;364(9):829–41.
2. 2. Balkau B. The DECODE study. Diabetes epidemiology: collaborative analysis of diagnostic criteria in Europe. Diabetes & Metabolism 2000;26(4):282–6.
3. 3. Li YW, Kao TW, Chang PK, Chen WL, Wu LW. Atherogenic index of plasma as predictors for metabolic syndrome, hypertension and diabetes mellitus in Taiwan citizens: a 9-year longitudinal study. Scientific Reports 2021;11(1).
4. 4. American Diabetes Association. Screening for Type 2 Diabetes. Diabetes Care 2003;27(Supplement 1):S11–4.
5. 5. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care 2004;28(Supplement 1):S4–36.
6. 6. Sharma N, Baliarsingh S. High fasting serum glucose in non-diabetic subjects ≥45 years is an indicator of future cardiovascular events as it is positively associated with atherogenic index of plasma. Archives of Physiology and Biochemistry 2012;118(2):43–6.
7. 7. Zhou K, Qin Z, Tian J, Cui K, Yan Y, Lyu S. The Atherogenic Index of Plasma: A Powerful and Reliable Predictor for Coronary Artery Disease in Patients With Type 2 Diabetes. Angiology 2021;72(10):934–41.
8. 8. Qin Z, Zhou K, Li Y, Cheng W, Wang Z, Wang J, et al. The atherogenic index of plasma plays an important role in predicting the prognosis of type 2 diabetic subjects undergoing percutaneous coronary intervention: results from an observational cohort study in China. Cardiovascular Diabetology 2020;19(1).

9. 9. Lumu W, Silver Bahendeka, Wesonga R, Kibirige D, Ronald Mutebi Kasoma, Ssendikwanawa E. Atherogenic index of plasma and its cardiovascular risk factor correlates among patients with type 2 diabetes in Uganda. African Health Sciences 2023;23(1):515–27.
10. 10. Turner RC, Millns H, Neil HAW, Stratton IM, Manley SE, Matthews DR, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS: 23). BMJ 1998;316(7134):823–8.
11. 11. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al. Cardiovascular Morbidity and Mortality Associated With the Metabolic Syndrome. Diabetes Care 2001;24(4):683–9.
12. 12. CDC. Estimates of Diabetes and Its Burden in the United States [Internet]. 2014. Available from: http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf
13. 13. Karve A, Hayward RA. Prevalence, Diagnosis, and Treatment of Impaired Fasting Glucose and Impaired Glucose Tolerance in Nondiabetic U.S. Adults. Diabetes Care 2010;33(11):2355–9.
14. 14. Færch K, Borch-Johnsen K, Holst JJ, Vaag A. Pathophysiology and aetiology of impaired fasting glycaemia and impaired glucose tolerance: does it matter for prevention and treatment of type 2 diabetes? Diabetologia 2009;52(9):1714–23.
15. 15. Abdul-Ghani M, DeFronzo RA, Jayyousi A. Prediabetes and risk of diabetes and associated complications. Current Opinion in Clinical Nutrition and Metabolic Care 2016;19(5):394–9.
16. 16. Balion CM, Raina PS, Gerstein HC, Santaguida PL, Morrison KM, Booker L, et al. Reproducibility of impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) classification: a systematic review. Clinical Chemical Laboratory Medicine 2007;45(9).
17. 17. Okosun IS, Seale JP, Lyn R, Davis-Smith YM. Improving Detection of Prediabetes in Children and Adults: Using Combinations of Blood Glucose Tests. Frontiers in Public Health 2015;3.
18. 18. Hsu WC, Yen AMF, Liou HH, Wang HC, Chen THH. Prevalence and Risk Factors of Somatic and Autonomic Neuropathy in Prediabetic and Diabetic Patients. Neuroepidemiology 2009;33(4):344–9.
19. 19. Grundy SM. Pre-Diabetes, Metabolic Syndrome, and Cardiovascular Risk. Journal of the American College of Cardiology 2012;59(7):635–43.
20. 20. Ford ES, Zhao G, Li C. Pre-Diabetes and the Risk for Cardiovascular Disease. Journal of the American College of Cardiology 2010;55(13):1310–7.
21. 21. Liu J, Grundy SM, Wang W, Smith SC, Lena Vega G, Wu Z, et al. Ten-year risk of cardiovascular incidence related to diabetes, prediabetes, and the metabolic syndrome. American Heart Journal 2007;153(4):552–8.