5198HbA1C correlates subclinical atherosclerosis in non-diabetes

Abstract Objective We investigated the association of lipid parameters and coronary atherosclerosis related to normal blood sugar (BS) and impaired fasting glucose (IFG), and factors contributing to coronary atherosclerosis. Methods We analyzed 1209 non-diabetic subjects who underwent coronary computed tomography angiography (CCTA). Atherosclerotic plaque pattern severity and patterns were evaluated based on serum glucose values. The association between low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) and plaque patterns in non-diabetic subjects were also analyzed. Results Non-diabetic subjects (age: 58.6±9.7 years; 861 male) were enrolled. Higher glucose levels were correlated with a higher prevalence of mixed plaque, significant (>50% stenosis) high-risk plaque, and calcified plaque in non-diabetic patients. Although serum LDL-C levels were mostly controlled by statin use, atherosclerotic plaques progressed, with increasing A1c values. Multivariate logistic regression analysis showed that age, male gender and A1C were independently associated with the presence of significant mixed plaques after considering BMI, blood pressure, renal function, lipid parameters, uric acid, and smoking habit. Conclusions Although decreasing HDL-C and increasing TG correlated with the presence and severity of coronary atherosclerosis, increasing A1c is independently associated with the presence of high-risk plaque in non-diabetes even if LDL-C is controlled by statin therapy.