A Glycemic Threshold of 90 mg/dl Promotes Early Signs of Atherosclerosis in Apparetly Healthy Overweight/Obese Subjects.

Background: Alterations of glucose metabolism represent well known risk factors for the atherosclerotic process and then for cardiovascular disease. Objective: To investigate the association between fasting glucose and early signs of atherosclerosis, by means of carotid intima-media thickness (c-IMT) in a population of apparently healthy overweight/obese subjects. In addition, we evaluated the possible existence of a glycemic threshold above which the risk of atherosclerosis significantly increases. Methods: 179 overweight/obese (mean BMI: 32 perpendicular to 5 kg/m(2)) subjects, 44 men, aged 40 perpendicular to 12.4 years, were enrolled in the study. Blood glucose, insulin, total cholesterol, high and low density lipoprotein cholesterol and triglycerides were detected in all subjects. The Homeostasis Model Assessment of insulin resistance index (HOMA-IR) was also obtained. All subjects underwent carotid echo color Doppler ultrasound to identify c-IMT. Results: In our population of obese/overweight subjects with insulin resistance (HOMA-IR=3.4 +/- 2), cIMT was positively related to male gender (r = 0.23, P<0.01), age (r = 0.53, P<0.001), waist circumference (r = 0.15, P=0.04), systolic and diastolic blood pressure (r=0.27, P<0.001 and r=0.24, P<0.001 respectively), fasting glucose (r=0.29, P<0.001), triglycerides (r= 0.16 P=0.03), total and low density lipoprotein cholesterol levels (r=0.25 P<0.001 and r=0.21, P<0.01 respectively). Only male gender and fasting glycemia were associated to c-IMT (P<0.01 and P<0.001, respectively) at multiple regression analysis. Conclusion: Blood glucose represented an independent predictor of atherosclerosis in our study population. Moreover, this seemed to be able to favor c-IMT progression for values greater than 90 mg/dl.