Journal article
Vascular dysfunction is associated with major adverse cardiovascular events in prediabetes: A cohort study
PloS one, Vol.20(6), e0324945
06/05/2025
DOI: 10.1371/journal.pone.0324945
PMCID: PMC12140275
PMID: 40471971
Abstract
Prediabetes is a growing public health concern that increases the risk of major adverse cardiovascular events (MACE). Vascular dysfunction worsens with hyperglycemia and is associated with MACE in several high-risk populations. However, it is unknown whether vascular dysfunction contributes to MACE in prediabetes. We hypothesized that vascular dysfunction is associated with elevated risk of MACE in prediabetes.
We conducted an observational study of 5742 adults (age 54.9 ± 11.5 years, 54% female) in the Framingham Offspring and Generation III cohorts. Prediabetes was defined using the ADA criteria. Endothelial function was determined via brachial artery flow-mediated dilation (BA-FMD), aortic stiffness via carotid-femoral pulse wave velocity (cfPWV), and coronary artery calcium (CAC) score via computed tomography. Stepwise selection models evaluated BA-FMD, cfPWV, and CAC score by prediabetes status. The association of BA-FMD, cfPWV, and CAC score with time to MACE was assessed via Cox proportional hazards regression.
Individuals with prediabetes had lower BA-FMD and higher cfPWV and CAC score (p < 0.001). In stepwise selection models, age, sex, smoking history, systolic blood pressure, triglycerides, high-density lipoprotein, low-density lipoprotein, and fasting glucose related to vascular dysfunction. After adjusting for traditional cardiovascular risk factors, BA-FMD (HR [95% CI], 0.93 [0.90,0.97]; p < 0.001) and CAC score >100 [HR [95% CI], 4.15 [2.24, 7.70]; p < 0.001)] were associated with MACE in prediabetes while cfPWV was not (p = 0.051).
Vascular dysfunction measured by BA-FMD independently associates with MACE in prediabetes. Therapies that target vascular dysfunction may reduce CVD risk in prediabetes.
Details
- Title: Subtitle
- Vascular dysfunction is associated with major adverse cardiovascular events in prediabetes: A cohort study
- Creators
- Dariya Kozlova - University of IowaColin Gimblet - University of IowaLinder Wendt - University of IowaSadaf Akbari - University of IowaAdeyinka Taiwo - University of IowaSanjana Dayal - University of IowaPatrick Ten Eyck - University of IowaAnna Stanhewicz - University of IowaJoel Trinity - University of UtahDiana Jalal - University of Iowa
- Resource Type
- Journal article
- Publication Details
- PloS one, Vol.20(6), e0324945
- DOI
- 10.1371/journal.pone.0324945
- PMID
- 40471971
- PMCID
- PMC12140275
- NLM abbreviation
- PLoS One
- ISSN
- 1932-6203
- eISSN
- 1932-6203
- Publisher
- PUBLIC LIBRARY SCIENCE
- Grant note
- National Institutes of Health: HL134738, T32 DK112751, HL169201, HL168630 National Center for Advancing Translational Sciences of the National Institutes of Health: UM1TR004403 Office of Research and Development and Department of Veterans Affairs: I01BX007087-06
This study was supported by grants from the National Institutes of Health (HL134738 for D.J., T32 DK112751 for C.G., and HL169201 and HL168630 for A.S.), the National Center for Advancing Translational Sciences of the National Institutes of Health (UM1TR004403), as well as the Office of Research and Development and Department of Veterans Affairs (I01BX007087-06) to S.D. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
- Language
- English
- Date published
- 06/05/2025
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Iowa Neuroscience Institute; Biostatistics; Surgery; Fraternal Order of Eagles Diabetes Research Center; Nephrology; Endocrinology and Metabolism; Health, Sport, and Human Physiology ; Internal Medicine; Design Biostat and Ethics
- Record Identifier
- 9984827333702771
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