Postprandial plasma glucose is an independent risk factor for increased carotid intima-media thickness in non-diabetic individuals

Postprandial (pp) hyperglycemia-frequently associated with an increase in c ardiovascular risk factors-may be damaging for the endothelium. So far, lit tle information exists how glucose, insulin and lipids may affect atheroscl erosis in the pp state. Therefore, we evaluated the relationship of pp hype rglycemia, insulin secretion and coronary risk factors to intima-media thic kness (IMT) in a non-diabetic risk population. In 403 subjects (147 males, 256 females), aged 40-70 years, in the majority relatives of index cases wi th type 2 diabetes-a 75 g oral glucose tolerance test was performed togethe r with measurement of insulin fractions, various risk factors and IMT of th e common carotid artery. We found a continuous rise of 2h pp insulin fracti ons along the quintiles of 2h pp plasma glucose. A significant increase of body mass index, waist to hip ratio, triglycerides and decrease of HDL-chol esterol was observed in the top quintile of 2h pp plasma glucose (8.24 grea ter than or equal to pp plasma glucose <11.1 mmol/l). Albuminuria was signi ficantly enhanced in the 5th quintile. In parallel, IMT was significantly i ncreased in the 5th quintile versus the bottom quintile of 2 h and maximal glucose (range 11.7-15.3 mmol/l) postprandially. After age and sex adjustme nt pp glucose and C-peptide, total cholesterol, triglycerides and HDL-chole sterol but not fasting plasma glucose were significantly correlated to IMT. In multivariate analysis age, male sex, pp plasma glucose, total and HDL-c holesterol were found to be independent risk factors for increased IMT. In conclusion, our data in a non-diabetic European risk population show that t he two top quintiles of pp plasma glucose are associated with a clustering of standard risk factors. Corresponding to this clustering of risk factors IMT was significantly increased in the top quintile of 2 h and maximal pp p lasma glucose. These data show that pp hyperglycemia may exert a noxious im pact on the arterial wall together with a cluster of anomalies typical for the metabolic syndrome. (C) 1999 Published by Elsevier Science Ireland Ltd. All rights reserved.