Peptide hormones and risk for future cardiovascular events among prediabetics: a 20-year follow-up in the OPERA study.

Background: Prediabetes has proven to have many unfavourable impacts on the cardiovascular system. Methods: The OPERA (Oulu Project Elucidating Risk of Atherosclerosis) study included 1045 middle-aged subjects followed from the years 1990-1993 to 2014. The focus was on peptide hormones. Results: Plasma resistin levels were higher among prediabetics ( p  = .001), particularly impaired glucose tolerance (IGT) ( p  < .001), but not impaired fasting glucose (IFG) patients than among normal glucose tolerance (NGT) or diabetes groups. Diabetics showed lower resistin levels than IGT subjects ( p  < .001). IGT or diabetes groups showed lower adiponectin and higher leptin levels compared to the NGT group ( p  < .001). The IFG group had the highest blood pressure and left ventricular mass index, even higher than the diabetic group. Diabetics had the highest, prediabetics (IFG + IGT) intermediate and NGT the lowest risk for CVD events during follow-up ( p  < .001). Among prediabetics, high plasma ghrelin was an independent predictor of CVD events ( p  < .05) in the Cox regression analysis although it did not significantly improve either classification or discrimination of the patients. Conclusions: Among glucose tolerance groups, patients with IGT had the highest resistin, but equally high leptin and low adiponectin levels as diabetics. Among prediabetics, ghrelin seems to predict independently cardiovascular events in the long term.KEY MESSAGEAmong glucose tolerance groups, patients with IGT had the highest resistin, but equally high leptin and low adiponectin levels as diabetics.Among prediabetics, ghrelin seems to predict independently cardiovascular events in the long term.