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    Nondiabetic Glucometabolic Status and Progression of Aortic Stiffness: The Whitehall II Study

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    graham64
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    Nondiabetic Glucometabolic Status and Progression of Aortic Stiffness: The Whitehall II Study

    Post by graham64 on Wed Feb 08 2017, 21:28

    Abstract

    OBJECTIVE Aortic stiffness is an important predictor of future morbidity and mortality. Diabetes is associated with increased aortic stiffness, but the importance of nondiabetic glucometabolic status for accelerated aortic stiffening is unclear. We tested the hypothesis that adverse glucometabolic status is associated with accelerated aortic stiffening in individuals without diabetes, independently of known risk factors for arterial stiffening.

    RESEARCH DESIGN AND METHODS Glucometabolic status and other cardiovascular risk factors were assessed at baseline in 2008–09, and carotid femoral pulse wave velocity (cfPWV) at baseline and follow-up in 2012–13, in 4,386 participants without diabetes of the Whitehall II Study.

    RESULTS The mean age of the cohort at cfPWV baseline was 60 years, and 74% were male. cfPWV increased from (mean ± SE) 8.30 ± 0.03 to 8.98 ± 0.04 m/s during 4 years of follow-up. At baseline, cfPWV was associated with fasting and 2-h postload glucose, HbA1c, and HOMA-insulin resistance (HOMA-IR). HbA1c and HOMA-IR were associated with progression of cfPWV after adjusting for physiological confounders and cardiovascular risk factors. A 1 SD higher HbA1c and HOMA-IR were associated with greater increases in cfPWV (0.11 m/s per 5 years [95% CI 0.04, 0.18], P = 0.003 and 0.09 m/s per 5 years [0.01, 0.17], P = 0.03, respectively). Additional adjustment for BMI weakened the association with HOMA-IR but not with HbA1c.

    CONCLUSIONS HbA1c is independently associated with accelerated progression of aortic stiffness in individuals without diabetes. These findings suggest that long-term glucometabolic status, even in individuals without diabetes, could be an important target for preventative strategies against vascular aging.

    http://care.diabetesjournals.org/content/early/2017/01/24/dc16-1773

    Unfortunately the full text is behind a paywall  Sad


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    chris c
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    Re: Nondiabetic Glucometabolic Status and Progression of Aortic Stiffness: The Whitehall II Study

    Post by chris c on Fri Feb 10 2017, 00:00

    Excellent! Backs up EPIC-Norfolk and the huge New Zealand studies (Elley et al, Brewer et al) which correlated A1c and cardiovascular risk/death from all causes starting from truly nondiabetic levels of 5% or less AND they never mentioned cholesterol once! The times they are a'changing!
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    Derek
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    Re: Nondiabetic Glucometabolic Status and Progression of Aortic Stiffness: The Whitehall II Study

    Post by Derek on Sat Feb 11 2017, 10:13

    @chris c wrote:Excellent! Backs up EPIC-Norfolk and the huge New Zealand studies (Elley et al, Brewer et al) which correlated A1c and cardiovascular risk/death from all causes starting from truly nondiabetic levels of 5% or less AND they never mentioned cholesterol once! The times they are a'changing!

    Hi Chris, Probably worse for us reactive hypoglyceamics than our hba1c implies since the blood glucose roller coaster fluctuates up and down far more on carbs than ordinary T2D's with the same hba1c!
    Derek
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    chris c
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    Re: Nondiabetic Glucometabolic Status and Progression of Aortic Stiffness: The Whitehall II Study

    Post by chris c on Sat Feb 11 2017, 21:35

    Well mine mostly stays between 4 - 6 NOW, though that was far from the case in the past. Agree though that this is yet another case where the A1c is a lousy indicator. Other studies (I think some are on Blood Sugar 101) show a correlation between A1c and microvascular damage but a correlation between glucose spikes and macrovascular damage. And of course hyperinsulinemia is in there somewhere too. Low carb improves all three factors.

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