ASYMPTOMATIC HYPERGLYCEMIA IS ASSOCIATED WITH INCREASED INTIMAL PLUS MEDIAL THICKNESS OF THE CAROTID-ARTERY

Atherosclerotic changes have not been demonstrated directly in asympto matic hyperglycaemic non-diabetic subjects, although high mortality du e to coronary heart disease has been reported. We measured arterial wa ll thickness non-invasively, in order to directly demonstrate atherosc lerosis of the carotid arteries of hyperglycaemic non-diabetic subject s and to evaluate its risk factors. The thicknesses of the intimal plu s medial complex (IMT) of the carotid arteries of 112 asymptomatic hyp erglycaemic non-diabetic subjects (aged 22-81, 95 males and 17 females ) were compared with those of 55 healthy male subjects and 211 non-ins ulin-dependent NIDDM male diabetic patients. The subjects were subgrou ped into impaired glucose-tolerant (IGT) subjects who had a 2-h glycae mic level of more than 7.8 mmol/l, and non-IGT subjects whose 2-h glyc aemic levels were within 6.7-7.7 mmol/l. Non-IGT and IGT subjects show ed significantly greater IMTs than age-matched healthy males and showe d no significant differences compared to age-matched NIDDM patients. M ultivariate analysis demonstrated that the risk factors for IMT of non -IGT and IGT subjects were age and systolic blood pressure. According to data on the accumulation of atherogenic risks (hypertension, dyslip idaemia, and smoking), IMT increased linearly in non-IGT and IGT subje cts. However, non-IGT and IGT subjects without hyperlipidaemia, hypert ension, or smoking risk still had significantly greater IMT than age-m atched normal males (1.019+/-0.063 vs 0.770+/- 0.111 mm, p < 0.05). Pr evalence of EGG-indicated coronary heart disease was significantly hig her in hyperglycaemic non-diabetic subjects and NIDDM with increased c arotid arterial wall thickness (IMT greater than or equal to 1.1 mm) t han in those without increased thickness (IMT < 1.1 mm). Asymptomatic hyperglycaemic non-diabetic subjects have increased thickness of their carotid arteries compared to age-matched male NIDDM patients. As one of several independent risk factors, mild hyperglycaemia advances athe rosclerosis, which leads to coronary heart disease.