Glucose intolerance is associated with C‐reactive protein and intima‐media anatomy of the common carotid artery in patients with coronary heart disease

AIMS: The purpose of this study was to examine the relationship between glucose intolerance and levels of hsCRP, calculated intima-media area (cIMa) of the carotid artery and flow-mediated dilation of the brachial artery in 122 patients with a myocardial infarction 1-12 months before inclusion and without known diabetes mellitus. METHODS: A standard oral glucose test (OGTT) was performed. Diabetes mellitus and impaired glucose tolerance (IGT) were defined according to the WHO criteria. Ultrasound measurement of cIMa of the carotid artery and flow-mediated dilation of the brachial artery were analyzed. RESULTS: Patients with diabetes mellitus had higher hs-CRP compared with patients with IGT and those patients with normal glucose tolerance (P < 0.05). The greater cIMa of the carotid artery in those with diabetes mellitus compared with normal subjects failed to reach conventional levels of significance (P = 0.058). hs-CRP and cIMa were associated with plasma glucose 120 min after the glucose load (P < 0.05). A multiple stepwise regression analysis, including all variables significantly associated with plasma-glucose 120 min after glucose ingestion as independent variables, revealed an independent and significant association between plasma-glucose 120 min after glucose ingestion in the OGTT and CRP (P < 0.05). No association was observed between glucose intolerance and endothelial function. CONCLUSION: Glucose intolerance was associated with hs-CRP and cIMa in patients with coronary heart disease without known diabetes mellitus. Thus, inflammation, atherosclerosis and impaired glucose tolerance are tightly interrelated disorders even in subjects without known diabetes mellitus.