Prediabetes increases the risk of major limb and cardiovascular events
Authors' conclusion
We demonstrated higher susceptibility to MALE and MACE in prediabetes compared to normoglycemic counterparts, notwithstanding lower HbA1c levels. Complications may manifest at an earlier prediabetes trajectory. Intensive lifestyle modification may improve the prognosis of severe prediabetes.
Study context
- Population
- Adult patients, electronic medical records of National Taiwan University Hospital, 2014–2019
- Participants
- 36,950 patients131,783 person-years
- Exposure
- Prediabetes vs normal glucose regulation
- Prediabetesn = 17,754
- Normal glucose regulation (NGR)n = 19,196reference
- Outcome
- Major adverse limb events (MALE) and MACE
Methodological detailssingle-centre electronic medical records, multivariable Cox regression
- Single-centre electronic medical records
- Multivariable Cox regression
Main finding
As reported in the abstract
Each group vs NGREstimate (95% CI)P value
Prediabetes
aHR (MALE) 1.26(1.10–1.46)
P = 0.001Prediabetes
aHR (MACE) 1.46(1.27–1.67)
P < 0.001- Kaplan-Meier: increased incidence of major adverse limb events (MALE) with prediabetes (log-rank)
- P = 0.024
- Kaplan-Meier: increased incidence of major adverse cardiovascular events (MACE) with prediabetes (log-rank)
- < 0.001
Observational data: associations, not effects.
Further findings
MALE risk by HbA1c category in prediabetes
- HbA1c 5.0-5.5%: aHR 1.78 (1.04-3.04)
- P = 0.036
- HbA1c 5.5-6.0%: aHR 1.29 [1.06-1.58]
- P = 0.012
- HbA1c 6.0-6.5%: aHR 1.39 [1.14-1.70]
- P < 0.001
- Elevated MALE risk commenced before HbA1c surpassed 5.0%
MACE risk by HbA1c category in prediabetes
- HbA1c 5.5-6.0%: aHR 1.67 [1.39-2.01]
- P < 0.001
- HbA1c 6.0-6.5%: HR 2.10 [1.76-2.51]
- P < 0.001
- Increased MACE risk observed when HbA1c exceeded 5.5%
Factors associated with MALE and MACE in prediabetes
- Advanced age, male gender, higher BMI, history of HF or AF
Original publication
Prediabetes increases the risk of major limb and cardiovascular events. Cardiovasc Diabetol. Published 19 December 2023. doi:10.
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