Ethnic differences in the relationship of prediabetes with the presence of target-organ disease

Abstract

Background: Cardiovascular risk is associated with prediabetes states. Ethnic differences in risks related to prediabetes have not been well studied. The purpose of this study was to examine the relationship between prediabetes and the presence of target-organ disease in terms of ethnic differences.

Methods: Cross-sectional analysis of the Multi-Ethnic Study of Atherosclerosis (MESA) involved a prospective cohort of 6814 participants aged 45-84 years in the US, including Black, white and hispanic subjects from an initial examination in 2000 with no known history of heart attack, stroke or diabetes. Main outcomes were comparisons of markers for coronary artery calcification (CAC), carotid stenosis more than 25%, Ankle-Brachial Index (ABI) less than 1.0 and presence of protein in urine (>30 mg/g) between participants with normal fasting glucose (NFG) and impaired fasting glucose (IFG), and between ethnic groups with prediabetes/IFG.

Results: There were 2457 white, 1548 black and 1229 Hispanic participants. After adjustments, there were no differences for each outcome between normal and prediabetes black and Hispanic subjects, whereas white participants with prediabetes had significantly higher odds of carotid stenosis (OR: 1.50), low ABI (OR: 1.77) and albuminuria (OR: 1.66) compared with whites with NFG. When comparing those with IFG/prediabetes by ethnicity, blacks and Hispanics had less CAC and carotid stenosis. In addition, Hispanics had lower reduced ABIs (OR: 0.35, 95% CI 0.19-0.65) compared with whites with IFG.

Conclusion: Prediabetes is related to the presence of several indicators of end-organ damage in white subjects, but not in blacks or Hispanics. Further longitudinal investigations into disease risks related to prediabetes in different ethnic groups are also needed.