Synergistic effects of glucose tolerance and BMI on cardiovascular events and all-cause mortality in a healthy population. CA.ME.LI.A study 7 year follow-up

Background The CA.ME.LI.A. study aimed to identify risk factors for metabolic and cardiovascular disease in a healthy population. Methods The population (n=2545; 1254 women) was stratified according to BMI (NBW < 25 kg/m2, OWO ≥ 25 kg/m2) and fasting glucose (NFG <100 mg/dL, IFG 100 - 125 mg/dL, DM ≥ 126 mg/dL). Incidence of cardiovascular (CV) events and all-causes mortality was studied by the Kaplan-Meier method using the log rank test. Univariate analysis was conducted with time-dependent Cox models. Results During the 7 years follow-up period, 80 deaths and 149 CV events occurred. IFG (HR: 2.81; p=0.005), DM (HR: 4.88; p=0.010) or OWO (HR: 2.78; p<0.001), all produced significant increases in CV events and deaths. IFG/OWO (HR: 5.51; p< 0.001) produced an additive effect, while DM/OWO (HR: 12.71; p<0.001), produced a multiplicative effect. In males, the DM/NBW group had higher incidence of cardiovascular events and deaths than the IFG/OWO group. On the other hand, in females, the IFG/OWO group had higher incidence of cardiovascular events and deaths than the DM/NBW group.In women there was a greater incidence of CV events in the IFG/OWO group (HR: 6.23; p<0.001) than in men in the same group (HR: 4.27; p< 0.001). All-cause mortality was progressively increased by IFG/DM and OWO with an apparently exponential effect in the combination DM/OWO (HR 11.78; p<0.001). Conclusions IFG/DM and OWO, progressively increased mortality for all causes and CV events. Females were more affected by overweight/obesity as compared to males.