BACKGROUND Prediabetes has recently been associated with subclinical atheromatous disease in the middle-aged population. Our aim was to characterize atheromatous plaque burden by the number of affected territories and the total plaque area in the prediabetes stage. METHODS Atheromatous plaque burden (quantity of plaques and total plaque area) was assessed in 12 territories from the carotid and femoral regions using ultrasonography in 6688 non-diabetic middle-aged subjects without cardiovascular disease. Prediabetes was defined by glycosylated hemoglobin (HbA1c) between 5.7 and 6.4% according to the American Diabetes Association guidelines. RESULTS Prediabetes was diagnosed in 33.9% (n = 2269) of the ILERVAS participants. Subjects with prediabetes presented a higher prevalence of subclinical atheromatous disease than participants with HbA1c < 5.7% (70.4 vs. 67.5%, p = 0.017). In the population with prediabetes this was observed at the level of the carotid territory (p < 0.001), but not in the femoral arteries. Participants in the prediabetes stage also presented a significantly higher number of affected territories (2 [1;3] vs. 1 [0;3], p = 0.002), with a positive correlation between HbA1c levels and the number of affected territories (r = 0.068, p < 0.001). However, atheromatosis was only significantly (p = 0.016) magnified by prediabetes in those subjects with 3 or more cardiovascular risk factors. The multivariable logistic regression model showed that the well-established cardiovascular risk factors together with HbA1c were independently associated with the presence of atheromatous disease in participants with prediabetes. When males and females were analyzed separately, we found that only men with prediabetes presented both carotid and femoral atherosclerosis, as well as an increase of total plaque area in comparison with non-prediabetic subjects. CONCLUSIONS The prediabetes stage is accompanied by an increased subclinical atheromatous disease only in the presence of other cardiovascular risk factors. Prediabetes modulates the atherogenic effect of cardiovascular risk factors in terms of distribution and total plaque area in a sex-dependent manner. Trial registration NCT03228459 (clinicaltrials.gov).

中文翻译：

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糖尿病前期动脉粥样硬化的特征：ILERVAS项目的横断面调查。

背景技术糖尿病前期已与中年人群的亚临床动脉粥样硬化疾病相关。我们的目的是通过糖尿病前期患病区域的数量和总斑块面积来表征动脉粥样斑块的负担。方法采用超声检查法对6688名无心血管疾病的非糖尿病中年受试者进行了超声检查，评估了颈动脉和股骨区域12个区域的动脉粥样斑块负担（斑块数量和总斑块面积）。根据美国糖尿病协会的指南，糖尿病前期定义为糖化血红蛋白（HbA1c）在5.7％至6.4％之间。结果ILERVAS参与者中33.9％（n = 2269）被诊断为糖尿病前期。糖尿病前期受试者的亚临床动脉粥样硬化疾病患病率高于HbA1c < 5.7％（70.4对67.5％，p = 0.017）。在患有糖尿病前期的人群中，这是在颈动脉区域的水平上观察到的（p <0.001），但在股动脉中却没有。糖尿病前期的参与者也表现出明显更高的患病区域数量（2 [1; 3] vs. 1 [0; 3]，p = 0.002），HbA1c水平与患病区域数量之间呈正相关（r = 0.068，p <0.001）。但是，在患有3种或3种以上心血管危险因素的受试者中，糖尿病前期仅将动脉粥样硬化显着放大（p = 0.016）。多变量logistic回归模型显示，建立良好的心血管危险因素以及HbA1c与糖尿病前期受试者中动脉粥样硬化疾病的存在独立相关。如果分别对男性和女性进行分析，我们发现只有患有糖尿病的男性与非糖尿病患者相比，同时具有颈动脉和股动脉粥样硬化，并且总斑块面积增加。结论仅在存在其他心血管危险因素的情况下，糖尿病前期伴随着亚临床动脉粥样硬化疾病的增加。前驱糖尿病以性别依赖性方式在分布和总斑块面积方面调节心血管危险因素的致动脉粥样硬化作用。试用注册NCT03228459（clinicaltrials.gov）。结论仅在存在其他心血管危险因素的情况下，糖尿病前期伴随着亚临床动脉粥样硬化疾病的增加。前驱糖尿病以性别依赖性方式在分布和总斑块面积方面调节心血管危险因素的致动脉粥样硬化作用。试用注册NCT03228459（clinicaltrials.gov）。结论仅在存在其他心血管危险因素的情况下，糖尿病前期伴随着亚临床动脉粥样硬化疾病的增加。前驱糖尿病以性别依赖性方式在分布和总斑块面积方面调节心血管危险因素的致动脉粥样硬化作用。试用注册NCT03228459（clinicaltrials.gov）。