Prediabetes Is Independently Associated with Subclinical Carotid Atherosclerosis: An Observational Study in a Non-Urban Mediterranean Population
Open accessAbstract
This was a prospective, observational study to compare the burden of subclinical atherosclerosis as measured by carotid ultrasonography in a cohort of subjects with prediabetes vs. subjects with normal glucose tolerance (NGT) from a non-urban Mediterranean population. Atherosclerosis was assessed through carotid intima-media thickness (c-IMT), the presence/absence of carotid plaques, and plaque number. Among 550 subjects included, 224 (40.7%) had prediabetes. The mean c-IMT and the prevalence of carotid plaque were significantly higher in the prediabetes group compared to the NGT group (0.72 vs. 0.67 mm, p < 0.001; and 37.9% vs. 19.6%; p < 0.001, respectively). Older age, male gender, and increased systolic blood pressure were positively correlated with c-IMT and were independent predictors of the presence of plaques. In contrast, prediabetes and low-density lipoprotein (LDL)-c were predictors of the presence of plaque (odds ratio [OR] = 1.64; 95% confidence interval [CI] = 1.05–2.57; p = 0.03 and OR = 1.01; 95% CI = 1.00–1.02; p = 0.006, respectively) together with tobacco exposure and the leukocyte count (OR = 1.77; 95% CI = 1.08–2.89; p = 0.023 and OR = 1.20; 95% CI = 1.05–1.38; p = 0.008, respectively). In a non-urban Mediterranean population, prediabetes was associated with established subclinical carotid atherosclerosis. These findings could have implications for the prevention and treatment of CV risk in these subjects before the first symptoms of cardiovascular disease appear.
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Diabetic patients face a 2- to 4-fold higher risk of developing CVD compared to the general population, with earlier onset and poorer prognosis.
“Epidemiological studies reveal that diabetic patients face a 2- to 4-fold higher risk of developing CVD compared to the general population, with earlier onset and poorer prognosis [83, 84].”
From Artificial intelligence-powered prediction of diabetic complications: from clinical data to molecular omics (2026) · cites this paper as [83]
The Introduction (page not provided) reports a two- to four-fold higher risk of atherosclerotic CVD and poorer cardiovascular prognosis in people with type 2 diabetes than in people without diabetes. It discusses atherosclerosis beginning during prediabetes, but does not establish that CVD begins earlier in diabetic patients than in the general population. (LLM, conf=0.88)
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- Authors
- Vilanova, M. B., Franch-Nadal, J., Falguera, M., Marsal, J. R., Canivell, S., Rubinat, E., Miró, N., Molló, À., Mata-Cases, M., Gratacòs, M., Castelblanco, E., & Mauricio, D.
- Affiliations
- Primary Health Care Center Igualada Nord, Consorci Sanitari de l’Anoia, Servei Català de la Salut, 08700 Igualada, Barcelona, Spain
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Barcelona, Spain
- Universitat de Lleida (ES)
- Unitat de Suport a la Recerca, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 25198 Lleida, Spain
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (ES)
- Institut Català de la Salut (ES)
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain
- Instituto de Salud Carlos III (ES)
- Corresponding author
- Castelblanco, Esmeralda
- ORCID
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2020-07-07
- Volume
- 9
- Issue
- 7
- Pages
- 2139
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC7408832
- OpenAlex
- W3040454836
- Cited by
- 16
- References
- 53
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 6 · 2021: 2
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, cc-by)
- Repositori ObertUDL (University of Lleida) (publishedVersion, cc-by)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, cc-by)
- Funders
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (NA)
- CIBER for Diabetes and Associated Metabolic Diseases (CIBERDEM) (NA)
- Carlos III National Institute of Health and European Regional Development Fund (PI15/0625 and PI18/0328)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- prediabetes, subclinical atherosclerosis, carotid intima-media thickness, carotid plaque, carotid ultrasound, LDL cholesterol, tobacco smoke exposure, white blood cell count, cardiovascular risk, Mediterranean populations
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