Nasir Khurram, Santos Raul D, Tufail Kashif, Rivera Juan, Carvalho Jose A M, Meneghello Romeu, Brady Thomas D, Blumenthal Roger S
Cardiac PET CT MRI Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Atherosclerosis. 2007 Dec;195(2):e155-60. doi: 10.1016/j.atherosclerosis.2007.05.025. Epub 2007 Jul 2.
: The objective of the study is to evaluate whether high fasting blood glucose (FBG) in the non-diabetic range (<126 mg/dl) is associated with subclinical coronary atherosclerosis as determined by coronary artery calcium (CAC) independent of clustering of metabolic syndrome (MS) risk factors.
METHODS & RESULTS: : Previously non-diabetic, 458 asymptomatic non-diabetic Brazilian men (mean age: 46+/-7 years, range: 29-65) underwent clinical consultation including FBG measurements and electron-beam tomography (EBT). The mean FBG of the study population was 88+/-10mg/dl. Overall, 190 (42%) of men had CAC>0. The prevalence of CAC was significantly higher among men with high-normal FBG (4th quartile: 94-125 mg/dl) versus normal FBG group (lower three quartiles: 66-93 mg/dl) (62% versus 35%, p<0.0001). In age adjusted analyses the odds ratio (OR) for any CAC among men with high-normal FBG versus normal FBG was 2.19 (95% CI: 1.33-3.58). On further adjustment for risk factors the relationship was slightly attenuated, however remained statistically significant (OR=1.78, 95% CI 1.05-3.00, p=0.03). In sub-stratified analyses high-normal FBG was associated with CAC among men without MS (OR: 1.99, 95% CI: 1.04-3.78) and with MS (OR: 2.12, 95% CI: 0.95-4.80). Similar relations with high-normal FBG were observed among individuals classified low risk (OR: 2.34, 95% CI: 1.14-4.83) as well intermediate high-risk men (OR: 1.95, 95% CI: 0.99-3.86) by Framingham risk score (FRS), respectively.
: Fasting blood glucose in the upper normal range appears to be associated with the presence of CAC in apparently non-diabetic Brazilian men.
本研究的目的是评估非糖尿病范围（<126mg/dl）内的高空腹血糖（FBG）是否与通过冠状动脉钙化（CAC）确定的亚临床冠状动脉粥样硬化相关，且独立于代谢综合征（MS）危险因素的聚集情况。
458名既往无糖尿病的无症状非糖尿病巴西男性（平均年龄：46±7岁，范围：29 - 65岁）接受了包括FBG测量和电子束断层扫描（EBT）在内的临床会诊。研究人群的平均FBG为88±10mg/dl。总体而言，190名（42%）男性的CAC>0。空腹血糖处于正常高值范围（第4四分位数：94 - 125mg/dl）的男性中CAC的患病率显著高于空腹血糖正常组（较低的三个四分位数：66 - 93mg/dl）（62%对35%，p<0.0001）。在年龄调整分析中，空腹血糖处于正常高值范围的男性与空腹血糖正常的男性相比，出现任何CAC的比值比（OR）为2.19（95%可信区间：1.33 - 3.58）。在进一步对危险因素进行调整后，这种关系略有减弱，但仍具有统计学意义（OR = 1.78，95%可信区间1.05 - 3.00，p = 0.03）。在亚分层分析中，空腹血糖处于正常高值范围与无MS的男性中的CAC相关（OR：1.99，95%可信区间：1.04 - 3.78），也与有MS的男性中的CAC相关（OR：2.12，95%可信区间：0.95 - 4.80）。通过弗明汉姆风险评分（FRS）分别分类为低风险（OR：2.34，95%可信区间：1.14 - 4.83）以及中高风险男性（OR：1.95，95%可信区间：0.99 - 3.86）的个体中，也观察到了与空腹血糖处于正常高值范围的类似关系。
在明显无糖尿病的巴西男性中，正常范围上限的空腹血糖似乎与CAC的存在相关。
