The relationship between impaired carbohydrate metabolism and cardiovascular disease risk

Abstract

Background: Diabetes mellitus is a significant risk factor for cardiovascular disease (CVD), a leading cause of death globally. Recent studies have highlighted the role of pre-diabetes, particularly impaired fasting glucose (IFG), in elevating CVD risk even before the onset of diabetes. Aim: This study aimed to analyze cardiovascular disease (CVD) risk across different stages of glycemic control. Materials and Methods: This cross-sectional study utilized data from a nationwide health screening program in Mongolia between 2022 and 2023, involving 120,266 adults after applying inclusion criteria. The participants were categorized based on fasting plasma glucose levels (NGT): normoglycemia, IFG, newly diagnosed diabetes, and longstanding diabetes. CVD risk was assessed using WHO risk prediction charts, considering factors like age, blood pressure, smoking status, and diabetes status. Results: CVD risk varied significantly with glycemic status. Among those with NGT, 62.9% were at low risk, while 31.2% were at moderate risk. In contrast, the IFG participants had 49.5% at low risk and 39.9% at moderate risk. Newly diagnosed diabetes showed 38.1% at low risk and 43.3% at moderate risk, while long-standing diabetes had 33.7% at low risk and 45.9% at moderate risk. Participants with central obesity demonstrated a higher proportion of moderate to very high CVD risk compared to those without central obesity, particularly in individuals with newly diagnosed and previously diagnosed diabetes. Conclusion: This study emphasizes the need for early cardiovascular risk assessment and intervention, even in pre-diabetic stages like IFG. Individuals with early-stage glucose metabolism impairments, such as pre-diabetes or newly diagnosed diabetes, exhibit an elevated risk of cardiovascular disease compared to those with normal carbohydrate metabolism. Individuals with central obesity face a significantly higher risk of cardiovascular disease relative to those without obesity.