Key result
Impaired fasting glucose across 1h-OGTT categories is linked to higher insulin resistance and MASLD prevalence.
Why the study?
The 1h-OGTT under development by the IDF focuses exclusively on 1h glucose, leaving it unknown whether cardiometabolic risk detection is improved by including assessment of impaired fasting glucose.
Does combining fasting glucose assessment with the 1-hour OGTT improve cardiometabolic risk stratification in screening populations?
Cross-Sectional (n=1,259)
Yes
Does combining fasting glucose assessment with the 1-hour OGTT improve cardiometabolic risk stratification in screening populations?
Adding fasting glucose assessment to the 1-hour OGTT improves the identification of patients at higher cardiometabolic risk across different ethnic groups.
May enhance 1h-OGTT risk stratification when fasting glucose is added; leaves open prospective outcome validation.
Introduction and Objective: The OGTT reveals both glucose tolerance and cardiometabolic risk. Interpretation of the 2h-OGTT is based on both fasting and 2h glucose. The 1h-OGTT, currently under development by the International Diabetes Federation (IDF), focuses exclusively on 1h glucose. Our goal was to determine if cardiometabolic risk detection by the 1h-OGTT was improved by including assessment of the presence of impaired plasma glucose (IFG) ≥100mg/dL. Methods: Two populations were evaluated, African descent and South Asians. The African descent population were healthy African Americans and African immigrants in America seeking health screening (n=712, age: 40±12y (mean±SD), BMI: 27.9±4.6, range 18.8 - 46.2 kg/m2) The South Asians were clinic attendees in Chennai, India who came for preventive health checkups (n=545, age: 51±15y, BMI: 27.4±5.7, range 17.4 - 47.2 kg/m2). Glucose tolerance status was determined by the 1h-OGTT using IDF criteria for 1h-glucose: normal glucose tolerance (NGT) <155 mg/dL, intermediate hyperglycemia (IH), 155 - 208 mg/dL, and DM ≥209 mg/dL. Each glucose tolerance category was sub-divided by presence or absence of IFG. Cardiometabolic risk factors evaluated were: insulin resistance (IR) determined by HOMA-IR, lipids (TG, LDL, TG/HDL, LDL/HDL), MASLD and eGFR. Results: In the African descent cohort, the prevalence of NGT, IH and DM were: 58% (413/712), 34% (242/712), and 8% (57/712), resp. and for South Asians were: 28% (154/547), 27% (150/547), and 45% (243/547), resp. In the African descent cohort, in all three glucose tolerance categories, IR and MASLD prevalence were higher in the presence of IFG (all P<0.05). In the NGT category, lipids were higher in the group with IFG (all P<0.01). In South Asians, the presence of IFG in the NGT group was associated with a higher prevalence of MASLD and lower eGFR (both P<0.01). Conclusion: Cardiometabolic risk was higher in the presence of IFG. Including assessment of fasting glucose when 1h-OGTT are performed enhances cardiometabolic risk stratification. Disclosure P. Thyparambil Aravindakshan: None. A. Bharadwaj: None. A. Shah: None. R. Anjana: None. G. Smith: None. C. DuBose: None. D.B. Sacks: Other - Crada; Current; Sebia.
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ARAVINDAKSHAN et al. (2026) conducted a cross-sectional in Cardiometabolic risk (n=1,259). Impaired fasting glucose (IFG) ≥100mg/dL vs. Absence of IFG was evaluated on Cardiometabolic risk factors including insulin resistance, lipids, MASLD, and eGFR (p=<0.05). The presence of impaired fasting glucose (≥100mg/dL) across 1h-OGTT categories was associated with a higher prevalence of insulin resistance and MASLD (P<0.05).
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