Prevalence of non-traditional cardiovascular disease risks factors among persons with impaired fasting glucose, impaired glucose tolerance, diabetes, and the metabolic syndrome: Analysis of the Third Health and Nutrition Examination Survey (NHANES III)

PURPOSE: To calculate the prevalence of non-traditional cardiovascular disease (CVD) risk factors across diabetes status and for persons with and without the metabolic syndrome. METHODS: Data were analyzed from the Third National Health and Nutrition Examination Survey for normal plasma glucose [< 100 mg/dl, n = 4589]; impaired fasting glucose [IFG, 100-125 mg/dl, n = 20081, diabetes [fasting glucose greater than or equal to 126 mg/dl or diabetes medication, n = 7501; and participants with and without the metabolic syndrome, n = 1938 and n = 5409, respectively. RESULTS: After adjustment for age, race, sex, body mass index, physical inactivity, cigarette smoking and alcohol consumption, a higher odds (p-trend < 0.01) of the metabolic syndrome, an elevated HOMA-insulin resistance index, chronic kidney disease, elevated C-reactive protein, high fibrinogen, and high white blood cell count was observed across diabetes status. After similar adjustment, the metabolic syndrome was associated with (odds ratio; 95% confidence interval) low apolipoprotein Al (2.27: 1.30,3.96), high apolipoprotein-B (2.97: 2.03,4.34), a higher HOMA insulin resistance index (5.25: 4.16, 6.63), chronic kidney disease (2.27: 1.42, 3.63), and elevated markers of inflammation [high white blood cell count (1.55: 1.14, 2.10), and elevated C-reactive protein (1.46: 1.06, 2.00)]. Among participants with IFG, the presence of impaired glucose tolerance (IGT) was associated with a higher prevalence of the HOMA insulin reistance index, 32.3%, high fibrinogen, 18.5%, and elevated C-reactive protein, 13.2%, compared to persons with IFG alone, 19.7%, 13.3% and 5.7%, respectively (each p less than or equal to 0.05). CONCLUSIONS: In this representative of the US population, an increased prevalence of non-traditional CVD risk factors was present among persons with diabetes, IGT and IFG compared to IFG alone, and the metabolic syndrome. (C) 2004 Elsevier Inc. All rights reserved.