Increased risk of cardiovascular disease in subjects with impaired fasting glucose or diabetes driven by multiple metabolic disorders rather than hyperglycaemia per se
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To compare and contrast the respective and relative bestowals of the metabolic syndrome and dysglycaemia upon cardiovascular disease (CVD) risk, 30378 subjects from 11 Chinese provinces (Chinese Multi-provincial Cohort Study or CMCS) were followed up for 10 years for coronary heart disease (CHD) and stroke events. In this cohort, metabolic syndrome was present in 18.2%, impaired fasting glucose (IFG) in 21.1% and diabetes in 6.8% of subjects. The prevalence of the metabolic syndrome was 38.1% in IFG and 48.7% in diabetes whereas in metabolic syndrome, the prevalence of IFG was 44.1% and that of diabetes 18.3%. Compared to subjects without metabolic syndrome, the hazard ratios of total CVD, CHD, and ischaemic stroke were significant and higher in subjects with metabolic syndrome regardless of glycaemic status, after adjusting for nonmetabolic factors. Furthermore, hyperglycaemia in the absence of any concomitant disorder was not associated with a significantly higher risk of CVD. The increased CVD risk in IFG/diabetes appears essentially driven by coexistent metabolic disorders rather than hyperglycaemia per se.
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