To assess the impact of changes in different glucose tolerance states on risk of incident cardiovascular disease (CVD)/coronary heart disease (CHD). A total of 4094 Iranians (43.9% men) aged ≥ 30 years, without diabetes and CVD at enrolment were included. The following categories were defined both at baseline visit and 3 years later (second visit): normal fasting glucose (NFG), normal glucose tolerance (NGT), NFG and NGT (NFG/NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and IFG and/or IGT (IFG/IGT). Changes in the categories, i.e. regression to normoglycemia, remaining in previous status and progression to diabetes were assessed. We used Cox’s proportional hazard models adjusted for traditional risk factors and their changes, to estimate the hazard ratio (HR) with 95% confidence interval (CI) of different changing categories for incident CVD/CHD. During a median follow-up of 12.42 years, 428 subjects (men = 265) experienced CVD. Considering persistent NFG/NGT as reference, participants who shifted from NFG/NGT to IFG/IGT showed a lower hazard of CVD in the fully adjusted model, HR 0.72 [95% CI 0.52–0.996, P = 0.048]. Moreover, subjects who shifted from IFG, IGT and IFG/IGT to diabetes had an increased risk of CVD/CHD. The risk however, was only statistically significant for those with IFG/IGT, 1.61 [(1.03–2.51), P = 0.04] for CVD and 1.75 [(1.10–2.78), P = 0.02] for CHD; considering IFG/IGT at both visits as reference. Furthermore, those who regressed from IFG/IGT to normoglycemia were at the same risk as those remained in IFG/IGT state, 1.12 [(0.79–1.60), P = 0.52] for CVD and 1.04 [(0.70–1.53), P = 0.85] for CHD. Among a subgroup of population with insulin data (n = 803) those with insulin resistance (IR) that converted to diabetes showed a higher risk for CVD, 3.68 [(1.49–9.06), P = 0.01] and CHD, 2.76 [(1.00–7.60), P = 0.05] events in the fully adjusted model. Among participants with IFG, IGT or IFG/IGT at baseline, only those who developed diabetes had a higher risk of developing CVD/CHD. Persistent IFG/IGT was not associated with higher risk, compared with those reverted to normoglycemia. Moreover, subjects who converted from NFG/NGT to incident IFG/IGT showed a signal for lower risk of CVD/CHD.

中文翻译：

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葡萄糖耐受不良状态的变化和发生心血管疾病的风险：德黑兰脂质和葡萄糖研究。

评估不同的糖耐量状态变化对心血管疾病（CVD）/冠心病（CHD）风险的影响。纳入了总共4094名年龄≥30岁的伊朗人（男性占43.9％），入院时未患有糖尿病和CVD。在基线访视和3年后（第二次访视）均定义了以下类别：正常的空腹血糖（NFG），正常的糖耐量（NGT），NFG和NGT（NFG / NGT），空腹血糖受损（IFG），血糖受损公差（IGT）和IFG和/或IGT（IFG / IGT）。评估了类别的变化，即回归到正常血糖水平，保持先前状态并发展为糖尿病。我们使用了针对传统风险因素及其变化进行调整的Cox比例风险模型，以95％置信区间（CI）估算不同变化类别的CVD / CHD的危险比（HR）。在中位随访期12.42年中，有428名受试者（男性= 265名）经历过CVD。考虑到持续性NFG / NGT作为参考，在完全调整的模型中，从NFG / NGT转移到IFG / IGT的参与者显示出较低的CVD危险，HR 0.72 [95％CI 0.52-0.996，P = 0.048]。此外，从IFG，IGT和IFG / IGT转移到糖尿病的受试者患CVD / CHD的风险增加。然而，对于IFG / IGT患者，该风险仅具有统计学意义，对于CVD为1.61 [（（1.03-2.51），P = 0.04]，对于CHD为1.75 [（1.10-2.78），P = 0.02]。两次访问均考虑IFG / IGT作为参考。此外，那些从IFG / IGT回归正常血糖的人与处于IFG / IGT状态的人处于相同的风险，即1.12 [（0.79-1.60），P = 0。CVD用52]和CHD用1.04 [（0.70-1.53​​），P = 0.85]。在具有胰岛素数据的亚人群（n = 803）中，具有胰岛素抵抗（IR）的糖尿病患者发生CVD的风险较高，为3.68 [（1.49–9.06），P = 0.01]，而CHD为2.76 [（1.00） –7.60），P = 0.05]事件在完全调整的模型中。在基线时患有IFG，IGT或IFG / IGT的受试者中，只有那些患有糖尿病的受试者发生CVD / CHD的风险更高。与恢复正常血糖的患者相比，持续性IFG / IGT与更高的风险无关。此外，从NFG / NGT转变为入射IFG / IGT的受试者显示出较低的CVD / CHD风险信号。49-9.06），P = 0.01]和CHD，在完全调整模型中为2.76 [（1.00-7.60），P = 0.05]事件。在基线时患有IFG，IGT或IFG / IGT的受试者中，只有那些患有糖尿病的受试者发生CVD / CHD的风险更高。与恢复正常血糖的患者相比，持续性IFG / IGT与更高的风险无关。此外，从NFG / NGT转变为入射IFG / IGT的受试者显示出较低的CVD / CHD风险信号。49-9.06），P = 0.01]和CHD，在完全调整模型中为2.76 [（1.00-7.60），P = 0.05]事件。在基线时患有IFG，IGT或IFG / IGT的受试者中，只有那些患有糖尿病的受试者发生CVD / CHD的风险更高。与恢复正常血糖的患者相比，持续性IFG / IGT与更高的风险无关。此外，从NFG / NGT转变为入射IFG / IGT的受试者显示出较低的CVD / CHD风险信号。