공복혈당장애에서 혈중 호모시스테인치와 죽상경화증과의 관계
Association of Blood Homocysteine levels with Subclinical Atherosclerosis in Impaired Fasting Glucose
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Prediabetes is the condition associated with the development of type 2 diabetes and a risk of cardiovascular disease. Abnormal homocysteine levels have been found to be associated with atherosclerosis in diabetes, but not well studied in pre-diabetes. In this study we investigated the relationship between blood homocysteine levels and subclinical atherosclerosis in the individuals with impaired fasting glucose. Method: Individuals with impaired fasting glucose with fasting blood glucose concentrations of 100-125 mg/dL (1,537 men and 1,563 women)were selected from 10,848 health examinees who underwent an ultrasonographic examination of carotid artery during health check-up over 20 yr. The subjects were divided into 4 quartile groups depending on homocysteine levels. We investigated the association of each homocysteine quartile with abnormal carotid intima-media thickness (CIMT) and carotid plaque by using logistic regression analysis. Results: Factors associated with abnormal CIMT and carotid plaque were age, homocysteine levels, blood pressure, and fasting blood glucose levels. Logistic regression analysis adjusted for gender and confounding factors showed that the third- and fourth- quartile homocysteine level groups had higher odds ratios ([OR]-95% confidence interval [ CI ])- for abnormal CIMT (1.656 [ 1.11-2.47], P =0.013, 1.966 [ 1.32-2.93], P =0.001, respectively) and for carotid plaque (1.608 [ 1.01-2.56 ], P =0.045, 1.913 [ 1.22-3.00 ], P =0.005, respectively) than did the first quartile group . Conclusion: Blood homocysteine levels showed a statistically significant correlation with subclinical atherosclerosis in individuals with impaired fasting glucose.
Abstract
Background: Prediabetes is the condition associated with the development of type 2 diabetes and a risk of cardiovascular disease. Abnormal homocysteine levels have been found to be associated with atherosclerosis in diabetes, but not well studied in pre-diabetes. In this study we investigated the relationship between blood homocysteine levels and subclinical atherosclerosis in the individuals with impaired fasting glucose. Method: Individuals with impaired fasting glucose with fasting blood glucose concentrations of 100-125 mg/dL (1,537 men and 1,563 women)were selected from 10,848 health examinees who underwent an ultrasonographic examination of carotid artery during health check-up over 20 yr. The subjects were divided into 4 quartile groups depending on homocysteine levels. We investigated the association of each homocysteine quartile with abnormal carotid intima-media thickness (CIMT) and carotid plaque by using logistic regression analysis. Results: Factors associated with abnormal CIMT and carotid plaque were age, homocysteine levels, blood pressure, and fasting blood glucose levels. Logistic regression analysis adjusted for gender and confounding factors showed that the third- and fourth- quartile homocysteine level groups had higher odds ratios ([OR]-95% confidence interval [ CI ])- for abnormal CIMT (1.656 [ 1.11-2.47], P =0.013, 1.966 [ 1.32-2.93], P =0.001, respectively) and for carotid plaque (1.608 [ 1.01-2.56 ], P =0.045, 1.913 [ 1.22-3.00 ], P =0.005, respectively) than did the first quartile group . Conclusion: Blood homocysteine levels showed a statistically significant correlation with subclinical atherosclerosis in individuals with impaired fasting glucose.
참고문헌 (32)
- Glümer C, "Prevalences of diabetes and impaired glucose regulation in a Danish population: the Inter99 study", Diabetes Care, 26, pp.2335~2340 (2003)
- Borch-Johnsen K, "Creating a pandemic of prediabetes: the proposed new diagnostic criteria for impaired fasting glycemia", Diabetologia, 47, pp.1396~1402 (2004)
- De Vegt F, "Relation of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch population: the Hoorn Study", JAMA, 285, pp.2109~2113 (2001)
- Ferrannini E, "2004 Mode of onset of type 2 diabetes from normal or impaired glucose tolerance", Diabetes, 53, pp.160~165 (2004)
- Gerstein HC, "Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta-analysis of prospective studies", Diabetes Res Clin Pract, 78, pp.305~312 (2007)
- Barr EL, "Continuous relationships between non-diabetic hyperglycemia and both cardiovascular disease and all cause mortality: the Australian Diabetes, Obesity, and Lifestyle (AusDiab) study", Diabetologia, 52, pp.415~424 (2009)
- Ning F, "Cardiovascular disease mortality in Europeans in relation to fasting and 2h plasma glucose levels within a normoglycemic range", Diabetes Care, 33, pp.2211~2216 (2010)
- Sourij H, "Post-challenge hyperglycemia is strongly associated with future macrovascular events and total mortality in angiographied coronary patients", Eur Heart J, 31, pp.1583~1590 (2010)
- "The World Health Report 2008" (2009)[URL]
- Simom A, "Intima-media thickness: A new tool for diagnosis and treatment of cardiovascular risk", J Hypertens, 20, pp.159~169 (2002)
- Lorenz MW, "Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis", Circulation, 115, pp.459~467 (2007)
- Wyman RA, "Ultrasound-detected carotid plaque as a predictor of cardiovascular events", Vasc Med, 11, pp.123~130 (2006)
- Stein JH, "Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine", J Am Soc Echocardiogr, 21, pp.93~111 (2008)
- Clarke R, "Hyperhomocysteinemia: an independent risk factor for vascular disease", N Engl J Med, 324, pp.1149~1155 (1991)
- Nygard O, "Total homocysteine and cardiovascular disease", J Intern Med, 246, pp.425~454 (1999)
- Danesh J, "Plasma homocysteine and coronary heart disease: systemic review of published epidemiological studies", J Cardiovasc Risk, 5, pp.229~232 (1998)
- Tawakol A, "Hyperhomocysteinemia is associated with impaired endothelium-dependent vasodilatation in humans", Circulation, 95, pp.1119~1121 (1997)
- Welch GN, "Homocysteine and atherothrombosis", N Engl J Med, 338, pp.1042~1050 (1998)
- Hoogeveen EK, "Hyperhomocysteinemia increases risk of death, especially in type 2 diabetes: 5-year follow-up of the Hoorn study", Circulation, 101, pp.1506~1511 (2000)
- Welch GN, "Mechanisms of disease: homocysteine and atherothrombosis", N Engl J Med, 338, pp.1043~1050 (1998)
- Liszka HA, "Prehypertension and cardiovascular mortality", Ann Fam Med, 3, pp.294~299 (2005)
- Casella IB, "A practical protocol to measure common carotid artery intima-media thickness", Clinics (Sao Paulo), 63, pp.515~520 (2008)
- American Diabetes Association, "Diabetes Care 2010;33 : S11-61", Diabetes Care, 33, pp.S11~S61 (2010)
- Abdul-Ghani MA, "Insulin secretion and action in subjects with impaired fasting glucose and impaired glucose tolerance: results from the Veterans Administration Genetic Epidemiology Study", Diabetes, 55, pp.1430~1435 (2006)
- Abdul-Ghani MA, "Contributions of β-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose", Diabetes Care, 29, pp.1130~1139 (2006)
- Abdul-Ghani MA, "The relative contribution of insulin resistance and β-cell failure to the transition from normal to impaired glucose tolerance varies in different ethnic groups", Diabetes Metab Syndr, 1, pp.105~112 (2007)
- Ford ES, "Pre-diabetes and the risk for cardiovascular disease", J Am Coll Cardiol, 55, pp.1310~1317 (2010)
- Tominaga M, "Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose: the Funagata Diabetes Study", Diabetes Care, 22, pp.920~924 (1999)
- DECODE Study Group., "Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria", Arch Intern Med, 161, pp.397~405 (2001)
- De Vegt F, "Hyperglycemia is associated with all-cause and cardiovascular mortality in the Hoorn population: the Hoorn Study", Diabetologia, 42, pp.926~931 (1999)
- Cowie CC, "Full accounting of diabetes and pre-diabetes in the U.S. population in 1988-1994 and 2005-2006", Diabetes Care, 32, pp.287~294 (2009)
- Vallence P, "Endothelial function and nitric oxide: clinical relevance", Heart, 85, pp.342~350 (2001)
