Background: To determine the risk of cardiovascular disease (CVD) in an Iranian population according to glucose tolerance status.
Methods and results: The study population consisted of 1752 men and 2273 women aged ≥40 years without CVD. After a median follow up of 7.6 years, 340 CVD events occurred (197 in men and 143 in women). Women generally had more Framingham risk score (FRS) than men (12.7 vs 11.9, P<0.001) and there was no difference between the FRS of newly diagnosed diabetes mellitus (NDM) and known diabetes mellitus (KDM) in both genders. Applying Cox proportional hazard modeling, after controlling risk factors, hazard ratios (HRs) and 95%confidence intervals for CVD in women with KDM and NDM were 3.88 (2.40 to 6.27) and 2.34 (1.39 to 3.95) and the corresponding values for men were 1.72 (1.002.95) and 1.52 (1.012.31) respectively. In age adjusted model, impaired fasting glucose or impaired glucose tolerance (IFG/IGT) was associated with 56% increased risk for CVD only in women (HR: 1.56, 95% CI 1.00 to 2.45). The multivariate HR for abnormal glucose metabolism (KDM, NDM and IFG/IGT) was significant in women 1.8 (1.2 to 2.7) but not in men 1 (0.7 to 1.4). Adjustment with FRS instead of risk factors did not change our results.
Conclusion: All diabetics should receive intensive primary prevention for CVD regardless of risk factors and whether they are NDM or KDM, with further emphasis on female with abnormal glucose metabolism.
25 - 29 Apr 2009
European Society of Endocrinology