Grading effect of abnormal glucose status on arterial stiffness and a new threshold of 2-h post-load glucose based on a Chinese community study

Aims/introduction: To investigate the relationship between various glucose metabolic status and arterial stiffness, and further explore the threshold of blood glucose indices for the risk of arterial stiffness.

Materials and methods: The present cross-sectional study included 4,851 individuals from a Chinese community. Overnight fasting blood glucose and 2-h post-load glucose were sampled. Arterial stiffness was measured as brachial-ankle pulse wave velocity. The association was examined using generalized linear regression models. The threshold effect was explored using two piecewise linear regression models by the smoothing plot.

Results: After adjustment for covariates, isolated impaired fasting glucose, isolated impaired glucose tolerance, combined glucose intolerance and newly diagnosed diabetes mellitus were associated with a greater risk of arterial stiffness compared with normal glucose tolerance (B = 18.09, 95% confidence interval [CI] 0.42-35.76, P = 0.045; B = 28.51, 95% CI: 3.40-53.62, P = 0.026; B = 60.70, 95% CI: 38.37-83.04, P < 0.001; B = 95.06, 95% CI: 71.88-118.25, P < 0.001, respectively). Furthermore, there was a non-linear relationship between 2-h post-load glucose and arterial stiffness. A threshold for 2-h post-load glucose of 6.14 mmol/L was observed for the risk of arterial stiffness.

Conclusions: Impaired fasting glucose, impaired glucose tolerance, combined glucose intolerance and newly diagnosed diabetes mellitus were related to a greater risk of arterial stiffness compared with normal glucose levels. A threshold for 2-h post-load glucose of 6.14 mmol/L probably exists for the risk of arterial stiffness.