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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1425027

Glucose-lowering medications and glucose levels as the major determinants of progression of carotid atherosclerosis in middle-aged adults and elders: a community-based prospective study

Provisionally accepted
Chao-Liang Chou Chao-Liang Chou 1,2Shu-Xin Lu Shu-Xin Lu 2Chun-Fang Cheng Chun-Fang Cheng 3Tzu-Wei Wu Tzu-Wei Wu 1Li-Yu Wang Li-Yu Wang 1*
  • 1 Mackay Medical College, New Taipei, Taiwan
  • 2 Mackay Memorial Hospital, Taipei, Taipei County, Taiwan
  • 3 New Taipei City Government, New Taipei City, Taiwan

The final, formatted version of the article will be published soon.

    Background: Few prospective studies explored the incidence and determinant of carotid atherosclerosis (CA) progression (CAP). This community-based prospective study focused on the effects of diabetes mellitus (DM) treatments and glucose levels on CAP risks.We followed up a group of 657 CA-positive middle-aged adults and elders for CAP.CAP was defined as an increase in the total number of carotid plaque and/or an increase in diameter stenosis by at least 10%.Results: After 4.05 years of followed-up, CAP was detected in 364 (55.4%) subjects. The multivariable-adjusted hazard ratios (HRs) were 1.805 (95% confidence interval [CI]:1.374-2.358) and 0.694 (95% CI: 0.510-0.944) for elevated fasting plasma glucose (eFPG; FPG100 mg/dL) and glucose-lowering medications (GLM), respectively. As compared to GLM-negative+eFPG-positive subjects, the multivariable-adjusted HRs were 0.497 (95% CI: 0.373-0.662), 0.537(95% CI: 0.306-0.942), and 0.586 (95% CI: 0.412-0.833) for GLM-negative+eFPG-negative, GLM-positive+eFPG-negative, and GLM-positive+ eFPG-positive subjects, respectively. The multivariable-adjusted risks of CAP were similar between GLM-negative+eFPG-negative and GLM-positive+ eFPG-positive subjects (p=0.77).Stratified analyses showed that the multivariable-adjusted HRs per 5.0 mg/dL increase in FPG were significantly increased among GLM-negative subjects (HR=1.131; 95% CI: 1.094-1.171) and non-significantly decreased among GLM-positive subjects (HR=0.985; 95% CI: 0.957-1.013).We found that more than 50% of CA-positive subjects had CAP in 4 years and higher FPG significantly increased and GLM significantly decreased the risks of CAP.Additionally, GLM and FPG demonstrated an interactive effect on CAP risks. It seems possible that GLM may induces effects beyond lowering glucose levels and subsequently lowers CAP risks.

    Keywords: List of Abbreviation BMI, body mass index, CI, confidence interval, CVD, Cardiovascular Diseases, DBP, diastolic blood pressure, DM, diabetes mellitus, FPG, Fasting Plasma Glucose, FTG, fasting triglycerides, HDL-C, high-density lipoprotein cholesterol

    Received: 30 May 2024; Accepted: 02 Oct 2024.

    Copyright: © 2024 Chou, Lu, Cheng, Wu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Li-Yu Wang, Mackay Medical College, New Taipei, Taiwan

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