Cardiovascular risk assessment in prediabetes: A hypothesis

Area of Science:

• Cardiology
• Endocrinology
• Metabolic Disorders

Background:

• Cardiovascular disease (CVD) screening is established for diabetes but not subclinical diabetes (prediabetes).
• Current guidelines often overlook individuals with prediabetes, potentially underestimating their CVD risk.
• Factors like hyperglycemia and hyperlipidemia, present in prediabetes, are significant CVD risk factors.

Purpose of the Study:

• To highlight the inadequate assessment of CVD risk in prediabetes within existing screening programs.
• To propose an improved hypothesis for CVD screening in prediabetes using blood glucose and oxidative damage.
• To advocate for a dedicated longitudinal study to develop new screening models for prediabetes.

Main Methods:

• Critically evaluate current CVD screening protocols for individuals below 50 years old with borderline risk factors.
• Hypothesize a novel approach combining blood glucose levels and an index of oxidative damage for enhanced CVD risk assessment.
• Propose a longitudinal study to develop and validate new screening models for prediabetes.

Main Results:

• Current screening may misclassify individuals with prediabetes as low-risk for CVD.
• Prediabetes, characterized by hyperglycemia, presents significant CVD risk, comparable to smokers in some aspects due to oxidative stress.
• A combination of blood glucose and oxidative damage markers could offer a more accurate CVD risk assessment.

Conclusions:

• Existing CVD screening programs are insufficient for detecting future risks in individuals with prediabetes.
• A refined screening strategy incorporating oxidative stress markers alongside glucose levels is necessary for prediabetes.
• Further longitudinal research is crucial to establish evidence-based CVD screening tools for prediabetes and undiagnosed diabetes.