Fasting glucose levels, incident diabetes, subclinical atherosclerosis and cardiovascular events in apparently healthy adults: A 12-year longitudinal study

Abstract

We aimed to study the association between fasting plasma glucose, diabetes incidence and cardiovascular burden after 10–12 years. We evaluated diabetes and cardiovascular events incidences, carotid intima-media thickness and coronary artery calcium scores in ELSA-Brasil (the Brazilian Longitudinal Study of Adult Health) baseline (2008–2010) of 1536 adults without diabetes in 1998. We used regression models to estimate association with carotid intima-media thickness (in mm), coronary artery calcium scores (in Agatston points) and cardiovascular events according to fasting plasma glucose in 1998. Adjusted diabetes incidence rate was 9.8/1000 person-years (95% confidence interval: 7.7–13.6/1000 person-years). Incident diabetes was positively associated with higher fasting plasma glucose. Fasting plasma glucose levels 110–125 mg/dL were associated with higher carotid intima-media thickness ( β = 0.028; 95% confidence interval: 0.003–0.053). Excluding those with incident diabetes, there was a borderline association between higher carotid intima-media thickness and fasting plasma glucose 110–125 mg/dL ( β = 0.030; 95% confidence interval: −0.005 to 0.065). Incident diabetes was associated with higher carotid intima-media thickness ( β = 0.034; 95% confidence interval: 0.015–0.053), coronary artery calcium scores ⩾400 (odds ratio = 2.84; 95% confidence interval: 1.17–6.91) and the combined outcome of a coronary artery calcium scores ⩾400 or incident cardiovascular event (odds ratio = 3.50; 95% confidence interval: 1.60–7.65). In conclusion, fasting plasma glucose in 1998 and incident diabetes were associated with higher cardiovascular burden.