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dc.contributor.authorSánchez Peña, Enric
dc.contributor.authorBetriu i Bars, M. Àngels
dc.contributor.authorLópez Cano, Carolina
dc.contributor.authorHernández García, Marta
dc.contributor.authorFernández i Giráldez, Elvira
dc.contributor.authorPurroy Garcia, Francisco
dc.contributor.authorBermúdez López, Marcelino
dc.contributor.authorFarràs-Sallés, Cristina
dc.contributor.authorBarril, Silvia
dc.contributor.authorPamplona Gras, Reinald
dc.contributor.authorRius, Ferran
dc.contributor.authorHernández, Cristina
dc.contributor.authorSimó, Rafael
dc.contributor.authorLecube Torelló, Albert
dc.description.abstractBACKGROUND: Prediabetes has recently been associated with subclinical atheromatous disease in the middle-aged population. Our aim was to characterize atheromatous plaque burden by the number of affected territories and the total plaque area in the prediabetes stage. METHODS: Atheromatous plaque burden (quantity of plaques and total plaque area) was assessed in 12 territories from the carotid and femoral regions using ultrasonography in 6688 non-diabetic middle-aged subjects without cardiovascular disease. Prediabetes was defined by glycosylated hemoglobin (HbA1c) between 5.7 and 6.4% according to the American Diabetes Association guidelines. RESULTS: Prediabetes was diagnosed in 33.9% (n = 2269) of the ILERVAS participants. Subjects with prediabetes presented a higher prevalence of subclinical atheromatous disease than participants with HbA1c < 5.7% (70.4 vs. 67.5%, p = 0.017). In the population with prediabetes this was observed at the level of the carotid territory (p < 0.001), but not in the femoral arteries. Participants in the prediabetes stage also presented a significantly higher number of affected territories (2 [1;3] vs. 1 [0;3], p = 0.002), with a positive correlation between HbA1c levels and the number of affected territories (r = 0.068, p < 0.001). However, atheromatosis was only significantly (p = 0.016) magnified by prediabetes in those subjects with 3 or more cardiovascular risk factors. The multivariable logistic regression model showed that the well-established cardiovascular risk factors together with HbA1c were independently associated with the presence of atheromatous disease in participants with prediabetes. When males and females were analyzed separately, we found that only men with prediabetes presented both carotid and femoral atherosclerosis, as well as an increase of total plaque area in comparison with non-prediabetic subjects. CONCLUSIONS: The prediabetes stage is accompanied by an increased subclinical atheromatous disease only in the presence of other cardiovascular risk factors. Prediabetes modulates the atherogenic effect of cardiovascular risk factors in terms of distribution and total plaque area in a sex-dependent manner. Trial registration NCT03228459 (
dc.description.sponsorshipThis work was partially supported by grants from the Diputació de Lleida and the Generalitat de Catalunya (2017SGR696 and SLT0021600250) and Menarini Spain S.A. CIBER de Diabetes y Enfermedades Metabólicas Asociadas and CIBER de Enfermedades Respiratorias are initiatives of the Instituto de Salud Carlos III.
dc.publisherBioMed Central
dc.relation.isformatofReproducció del document publicat a:
dc.relation.ispartofCardiovascular Diabetology, 2019, vol. 18, núm. 1: 154, p. 1-12
dc.rightscc-by (c) Sánchez Peña, Enric et al., 2019
dc.subjectCardiovascular risk factors
dc.subjectGlycosylated hemoglobin
dc.subjectSubclinical atheromatous disease
dc.titleCharacteristics of atheromatosis in the prediabetes stage: a cross-sectional investigation of the Ilervas project

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