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Post-challenge hyperglycemia in older adults is associated with increased cardiovascular risk profile

Jill P Crandall1, Harry Shamoon, Hillel W Cohen

  • 1The Institute of Aging Research, Albert Einstein College of Medicine, Bronx, New York 10461, USA. crandall@aecom.yu.edu

The Journal of Clinical Endocrinology and Metabolism
|February 12, 2009
PubMed

Insights

Post-challenge hyperglycemia (PCH) in older adults is linked to metabolic issues and increased cardiovascular disease risk. This study reveals PCH is associated with significant metabolic dysregulation and a proatherosclerotic vascular profile.

Area of Science:

  • Gerontology
  • Endocrinology
  • Cardiovascular Medicine

Background:

  • Post-challenge hyperglycemia (PCH) is prevalent in older adults, yet often unrecognized clinically.
  • PCH is associated with elevated cardiovascular disease (CVD) risk and mortality.
  • The specific glycemic exposure and CVD risk profile in elderly individuals with PCH remain underexplored.

Purpose of the Study:

  • To characterize the metabolic and CVD risk profile of elderly individuals with PCH.
  • To determine the impact of acute postprandial metabolic changes on vascular biomarkers in this population.

Main Methods:

  • A cross-sectional study design was employed.
  • Participants included older adults with normal glucose tolerance (n=30) and PCH (n=28).
  • Fasting and postprandial levels of glucose, insulin, lipids, inflammatory markers (hs-CRP, PAI-1, adiponectin), and endothelial function (EndoPat) were assessed after a standard meal challenge.

Main Results:

  • Subjects with PCH exhibited higher fasting glucose, glycosylated hemoglobin, and insulin resistance compared to controls.
  • PCH was associated with elevated fasting high-sensitivity C-reactive protein (hs-CRP) and lower adiponectin levels.
  • Postprandial glucose, insulin, and lipid responses were amplified in the PCH group, alongside increased plasminogen activator inhibitor-1 (PAI-1).
  • Endothelial function, measured by reactive hyperemia peripheral arterial tonometry (RHPAT), declined postprandially exclusively in the PCH group.

Conclusions:

  • Older adults with PCH demonstrate substantial fasting and postprandial metabolic dysregulation.
  • This metabolic derangement is accompanied by a vascular profile that is both proatherosclerotic and prothrombotic.
  • These findings highlight the clinical significance of identifying and managing PCH in the elderly to mitigate cardiovascular risk.
Abstract

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