Higher 2-h post-MMTT glucose and CGM measures were associated with higher odds of intermediate or high 10-year CVD risk (ORs 1.21-1.70, p<0.001) in adults without diabetes.
Observational (n=1,374)
Do CGM-derived measures and 2-h post-MMTT glucose associate with estimated 10-year CVD risk in adults without diabetes?
Dynamic measures of glycemia, such as CGM-derived metrics and post-MMTT glucose, are associated with higher estimated 10-year CVD risk in adults without diabetes, independent of fasting plasma glucose.
Effect estimate: OR 1.21-1.70
p-value: p=<0.001
Introduction and Objective: Prediabetes and diabetes are well-established risk factors for CVD; yet how dynamic glucose fluctuations relate to CVD risk in those without diabetes remains unclear. Methods: We included 1374 Framingham Heart Study participants free of diabetes and CVD (3rd Generation, Exam 4), who had ≥3 days of continuous glucose monitor (CGM) and completed a mixed meal tolerance test (600kcal MMTT; 75g carbohydrate, 21g fat, 29g protein). The 10-year total CVD risk was estimated using the Predicting Risk of CVD EVENTs (PREVENT) base equations. We performed multinomial regression to relate standardized CGM-derived measures and 2-h post-MMTT glucose with PREVENT categories (low 5%reference, borderline 5-7.5%, intermediate/high ≥7.5%), and linear regression for log-transformed PREVENT scores (continuous). All models were adjusted for fasting plasma glucose (FPG). Results: Among participants (55.8% female, 56% normoglycemic), the mean age was 59.3y and BMI was 27.9kg/m². Higher 2-h post-MMTT glucose and CGM measures (including mean glucose and time 140mg/dL) were associated with higher odds of intermediate/high CVD risk (ORs: 1.21-1.70, all p0.001), and a higher overall 10-year CVD risk (per 1 SD increase, β:0.07-0.16, all p0.001), adjusting for FPG (Figure). Conclusion: Dynamic measures of glycemia may serve as biomarkers that precede development of overt dysglycemia, potentially providing additional integrated information about potential CVD risk, independent of FPG. Disclosure B. Bakhshi: None. V. Xanthakis: None. H. Lin: None. J.M. Murabito: None. D. Steenkamp: Research Support; Current; Abbott Diabetes. Research Support; Ended; Novo Nordisk Foundation. Research Support; Current; Insulet Corporation. D.M. Lloyd-Jones: None. M. Nayor: None. M.E. Walker: None. N. Spartano: Research Support; Current; Dexcom, Inc. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK129305), National Heart, Lung and Blood Institute (N01-HC25195, HHSN268201500001I, 75N92019D00031)
Bakhshi et al. (Fri,) conducted a observational in Adults without diabetes and cardiovascular disease (n=1,374). Higher 2-h post-MMTT glucose and CGM measures was evaluated on Intermediate/high 10-year CVD risk (PREVENT score ≥7.5%) (OR 1.21-1.70, p=<0.001). Higher 2-h post-MMTT glucose and CGM measures were associated with higher odds of intermediate or high 10-year CVD risk (ORs 1.21-1.70, p<0.001) in adults without diabetes.
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