Cardiovascular Risk Profile in Subjects With Prediabetes and New-Onset Type 2 Diabetes Identified by HbA 1c According to American Diabetes Association Criteria OBJECTIVE We investigated the cardiovascular risk profile in subjects with prediabetes and new-onset type 2 diabetes identified by glycated hemoglobin A 1c (HbA 1c ) according to the new American Diabetes Association criteria. RESEARCH DESIGN AND METHODS Arterial stiffness, intima-media thickness (IMT), soluble receptor for advanced glycation end products (sRAGEs), and oral glucose tolerance test (OGTT) were evaluated in 274 subjects without a previous history of diabetes. The subjects were stratified into three groups according to the HbA 1c levels. RESULTS The subjects with prediabetes (n = 117, HbA 1c 5.7–6.4% [39–46 mmol/mol]) showed a higher augmentation (Aug), augmentation index (AugI), and IMT com- pared with those with lower HbA 1c ; however, these values were similar to those of subjects with HbA 1c >6.5% (48 mmol/mol). When we further analyzed the subjects with prediabetes but included only subjects with normal glucose tolerance (NT) in the analysis, AugI and IMT still remained significantly higher than their levels in control subjects with HbA 1c <5.7% (39 mmol/mol). After multiple regression analyses including several cardiovascular risk factors, only HbA 1c , age, and sRAGE were significantly correlated with the IMT, whereas age and 1-h postload glucose were the major determinants of AugI. CONCLUSIONS Our data show that subjects with prediabetes according to HbA 1c , but with both NT according to the OGTT and normal fasting glycemia, have an altered IMT and AugI. These data suggest that a simple, reproducible, and less expensive marker such as HbA 1c may be better able to identify prediabetic subjects at high cardio- vascular risk compared with fasting glycemia or OGTT alone. Diabetes Care 2014;37:1447–1453 | DOI: 10.2337/dc13-2357 Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy Corresponding author: Francesco Purrello, fpurrell@unict.it. Received 10 October 2013 and accepted 20 December 2013. © 2014 by the American Diabetes Association. See http://creativecommons.org/licenses/by- nc-nd/3.0/ for details. Antonino Di Pino, Roberto Scicali, Salvatore Calanna, Francesca Urbano, Concetta Mantegna, Agata Maria Rabuazzo, Francesco Purrello, and Salvatore Piro Diabetes Care Volume 37, May 2014 1447 CARDIOVASCULAR AND METABOLIC RISK Downloaded from http://diabetesjournals.org/care/article-pdf/37/5/1447/621916/1447.pdf by guest on 18 June 2022