Background: Alterations of glucose metabolism represent well known risk factors for the
atherosclerotic process and then for cardiovascular disease.
Objective: To investigate the association between fasting glucose and early signs of atherosclerosis, by
means of carotid intima-media thickness (c-IMT) in a population of apparently healthy overweight/obese
subjects. In addition, we evaluated the possible existence of a glycemic threshold above which the risk of
atherosclerosis significantly increases.
Methods: 179 overweight/obese (mean BMI: 32 ± 5 kg/m2) subjects, 44 men, aged 40 ± 12.4 years, were
enrolled in the study. Blood glucose, insulin, total cholesterol, high and low density lipoprotein
cholesterol and triglycerides were detected in all subjects. The Homeostasis Model Assessment of insulin
resistance index (HOMA-IR) was also obtained. All subjects underwent carotid echo color Doppler
ultrasound to identify c-IMT.
Results: In our population of obese/overweight subjects with insulin resistance (HOMA-IR=3.4 ± 2), c-
IMT was positively related to male gender (r = 0.23, P<0.01), age (r = 0.53, P<0.001), waist
circumference (r = 0.15, P=0.04), systolic and diastolic blood pressure (r=0.27, P<0.001 and r=0.24,
P<0.001 respectively), fasting glucose (r=0.29, P<0.001), triglycerides (r= 0.16 P=0.03), total and low
density lipoprotein cholesterol levels (r=0.25 P<0.001 and r=0.21, P<0.01 respectively). Only male
gender and fasting glycemia were associated to c-IMT (P<0.01 and P< 0.001, respectively) at multiple
Conclusion: Blood glucose represented an independent predictor of atherosclerosis in our study
population. Moreover, this seemed to be able to favor c-IMT progression for values greater than 90 mg/dl.