Aim: Evaluate if cardiovascular (CV) risk factors increase at a greater rate during the prediabetes (preDM) stage rather than the diabetes (DM) stage by sex.

Methods: We pooled data from the Atherosclerosis Risk in Communities Study and the Multi-Ethnic Study of Atherosclerosis. The CV risk outcome was the metabolic syndrome (MetS) severity z-score derived from components of waist circumference, HDL, triglycerides, SBP, and fasting glucose accounting for the weight of each component. The score was calculated for participants at visits 1 to 4 (3-year interval between visits) . We used linear mixed regressions to model the MetS z-score over time in men and women by levels of glucose (normal <100, preDM 100-125, DM ≥126 mg/dL) , adjusting for age, race, education, smoking, medication & cohort. A sex interaction was added to assess if the magnitude of risk factor changes over time differs by sex in each glucose level.

Results: Men and women had a greater rate of change in MetS severity during the preDM than the DM stage. Women had a significantly greater increase of MetS severity than men during the preDM stage, while men had a significantly greater increase in the DM stage than women.

Conclusion: A more rapid increase in MetS severity occurred in preDM than in DM. Women exhibited a faster increase in MetS severity compared to men during the preDM stage. Greater attention should be given to CV risk in women with preDM.


Y.Yoshida: None. Z.Chen: n/a. R.L.Baudier: None. M.Krousel-wood: None. A.H.Anderson: None. V.Fonseca: Consultant; Abbott, Asahi Kasei Corporation, Bayer AG, Novo Nordisk, Sanofi, Research Support; Fractyl Health, Inc., Jaguar Gene Therapy, Stock/Shareholder; Abbott, Amgen Inc., BRAVO4Health, Mellitus Health. F.Mauvais-jarvis: Consultant; Mithra Pharmaceutical.


NIH K12HD043451

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