Glycemic and metabolic sub-classification of prediabetes and risk factors for cardiovascular disease in the D2d cohort.

Prediabetes represents a spectrum of metabolic abnormalities, including insulin resistance and secretory impairment, that carries increased cardiovascular disease (CVD) risk. It is unclear whether specific glycemic and metabolic sub-classifications are associated with CVD risk. This cross-sectional analysis of 3946 participants from the Vitamin D and Type 2 Diabetes (D2d) study cohort aimed to determine the associations between various baseline CVD risk factors, glycemic sub-classifications of prediabetes (FPG, 2hPG, and HbA1c), and measures of insulin sensitivity and secretion from an OGTT. The metabolic syndrome and atherosclerotic cardiovascular disease (ASCVD) risk scores were determined for tertiles of insulin sensitivity (HOMA2S) and insulinogenic index (IGI). Unadjusted analyses showed elevated CVD risk factors in the lowest tertile for both IGI and HOMA2S. After adjustment for age, gender, race, obesity, and smoking status, the association remained between HOMA2S and ASCVD score ( In conclusion, multiple metabolic (HOMA2S, IGI) and glycemic criteria of prediabetes (FPG, 2hPG, & HbA1c) are needed to fully recognize the elevated CVD risk profile that can manifest in prediabetes.

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© 2023 Published by Elsevier B.V.

Déclaration de conflit d'intérêts

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sun Kim reports a relationship with Aligos Therapeutics that includes: consulting or advisory. Sun Kim reports a relationship with GI Dynamics that includes: consulting or advisory. Lisa Neff reports a relationship with Eli Lilly and Company that includes: employment and equity or stocks. Lisa Neff reports a relationship with Amryt Pharmaceuticals DAC that includes: funding grants. Lisa Neff reports a relationship with Novo Nordisk Inc that includes: funding grants. Vanita Aroda reports a relationship with Applied Therapeutics Inc that includes: consulting or advisory. Vanita Aroda reports a relationship with Duke University that includes: consulting or advisory. Vanita Aroda reports a relationship with Novo Nordisk Inc that includes: consulting or advisory. Vanita Aroda reports a relationship with Pfizer that includes: consulting or advisory. Vanita Aroda reports a relationship with Sanofi that includes: consulting or advisory. Vanita Aorda reports a relationship with Applied Therapeutics Inc that includes: funding grants. Vanita Aroda reports a relationship with Eli Lilly and Company that includes: funding grants. Vanita Arodaa reports a relationship with Premier Inc that includes: funding grants. Vanita Aroda reports a relationship with Novo Nordisk Inc that includes: funding grants. Vanita Aroda reports a relationship with Sanofi that includes: funding grants. Sangeeta Kashyap reports a relationship with GI Dynamics that includes: consulting or advisory. Sangeeta Kashyap reports a relationship with Gila Therapeutics that includes: consulting or advisory. Sangeeta Kashyap reports a relationship with Fractyl Laboratories that includes: consulting or advisory. Consultant/Educational Activities: American College of Cardiology (institution), American Diabetes Association, Cardiometabolic Health Congress, IMNE (personal), Liberum (personal), Medscape/WebMD (personal and institution), PeerView (personal and institution) - VA. Committees: I serve on the ADA Professional Practice Committee which reviews and updates the American Diabetes Association's annual Standards of Medical Care in Diabetes (2020–2022). I serve on the ADA-EASD working group on treatment of hyperglycemia (2021-present) - VA Associate Editor of the Journal of Clinical Endocrinology and Metabolism - SK