Fasting Glucose is a Useful Indicator for Cerebrovascular Risk in Non-Diabetic Koreans: Association With Oxidative Stress and Inflammation

Diabetes and impaired fasting glucose are associated with incidence of cerebro-/cardio-vascular diseases. This study hypothesized that fasting glycemic status may reflect cerebrovascular risk in non-diabetic Koreans. Fasting glycemic status, lipid profiles, oxidative stress, and inflammation markers were measured in non-diabetic subjects (healthy controls, n = 112 and stroke n = 41). Systolic blood pressure, fasting glucose, glycated hemoglobin (HbA1C), triglycerides, high sensitivity C-reactive protein (hs-CPR), interleukin-6, and tumor necrosis factor-alpha were higher, and high density lipoprotein (HDL)-cholesterols were lower in patients with stroke than healthy controls. Fasting glucose positively correlated with hs-CRP, interleukin-6, tumor necrosis factor-alpha, oxidized low density lipoprotein (LDL) and malondialdehyde. The significances continued or at least turned to a trend after adjustments for confounding factors. Multiple regression analyses revealed that fasting glucose was mainly associated with cerebrovascular risk (beta'-coefficient = 0.284, p < 0.0001) together with age, systolic blood pressure, total cholesterol, hs-CRP, body mass index, dietary poly unsaturated fatty acid/saturated fatty acid (PUFA/SFA), and HbA1C (r2 = 0.634, p = 0.044). The subjects were subdivided by their fasting glucose levels [normal fasting glucose: 70-99 mg/dL, n = 91 [NFG-control] and n = 27 [NFG-stroke]; higher fasting glucose: 100-125 mg/dL, n = 21 [HFG-control] and n = 14 [HFG-stroke]). In both controls and stroke patients, HFG groups show higher triglyceride, total- and LDL-cholesterol and lower HDL-cholesterol than NFG groups. Control-HFG group showed significantly higher levels of oxidative stress and inflammation than control-NFG group. Stroke-HFG group also showed significantly higher inflammatory levels than stroke-NFG group, moreover the highest among the groups. Additionally, stroke-NFG group consumed higher PUFA/SFA than stroke-HFG group. Fasting glucose may be a useful indicator for cerebrovascular risk in non-diabetic individuals which may be mediated by oxidative stress and inflammation status.

Glycated Hemoglobin is a Better Predictor than Fasting Glucose for Cardiometabolic Risk in Non-diabetic Korean Women

This study aimed to investigate if glycated hemoglobin (HgbA1C) as compared to fasting blood glucose is better for reflecting cardiometabolic risk in non-diabetic Korean women. Fasting glucose, HgbA1C and lipid profiles were measured in non-diabetic women without disease (n = 91). The relationships of fasting glucose or HgbA1C with anthropometric parameters, lipid profiles, and liver and kidney functions were analyzed. Both fasting glucose and HgbA1C were negatively correlated with HDL-cholesterol (r = -0.287, p = 0.006; r = -0.261, p = 0.012), and positively correlated with age (r = 0.202, p = 0.008; r = 0.221, p = 0.035), waist circumference (r = 0.296, p = 0.005; r = 0.304, p = 0.004), diastolic blood pressure (DBP) (r = 0.206, p = 0.050; r = 0.225, p = 0.032), aspartate transaminase (AST) (r = 0.237, p = 0.024; r = 0.368, p < 0.0001), alanine transaminase (ALT) (r = 0.296, p = 0.004; r = 0.356, p = 0.001), lipid profiles including triglyceride (r = 0.372, p < 0.001; r = 0.208, p = 0.008), LDL-cholesterol (r = 0.315, p = 0.002; r = 0.373, p < 0.0001) and total cholesterol (r = 0.310, p = 0.003; r = 0.284, p = 0.006). When adjusted for age and body mass index, significant relationships of DBP (r = 0.190, p = 0.049), AST (r = 0.262, p = 0.018), ALT (r = 0.277, p = 0.012), and HDL-cholesterol (r = -0.202, p = 0.049) with HgbA1C were still retained, but those with fasting glucose disappeared. In addition, the adjusted relationships of LDL-cholesterol and total cholesterol with HgbA1C were much greater than those with fasting glucose. These results suggest that glycated hemoglobin may be a better predictor than fasting glucose for cardiometabolic risk in non-diabetic Korean women.