A longitudinal study on the incidence of cardiovascular events in a population of Northern Italy

INTRODUCTION AND OBJECTIVES The CA.ME.LI.A (CArdiovascular risks, MEtabolic syndrome, Liver, and Autoimmune disease) project is a study aimed at identifying the risk factors for cardiovascular disease (CV) in the population of Abbiategrasso. In this work we aim to evaluate whether glucose intolerance (IFG) and/or overweight/obesity (OWO) may be associated with an increased CV risk. MATERIALS AND METHODS Time 0 was defined as the time of study enrollment (2009); the observation ends on August 30, 2017, or at the 1st CV event (healing or death), or with the subject's loss to follow-up. The study of the incidence of events was conducted with the Kaplan-Meier method using the log rank test. Univariate analysis was performed with time-dependent Cox models. The population (n=2545, 1251 men, 1254 women) was stratified into 6 groups: 1. Normal glucose tolerance (NGT) (fasting glucose, FG<110 mg/dL)/ BMI≤24.9 kg/m2 (regular weight, NBW); 2. NGT/BMI ≥25 kg/m2 (overweight or obese, OWO); 3. Impaired Fasting Glucose (IFG) (FG 110-125 mg/dL)/NBW; 4. IFG/OWO; 5. Diabetes (DM) (FG≥126 mg/dL)/NW; 6.DM/OWO. RESULTS During the follow-up period, 163 CV events occurred with an incidence rate of approximately 1.5 per 100 patient-years; men had more events than women (106 vs 57; 4.2% vs 2.2%). DM had a higher incidence of events than both IFG and NGT (IFG 13% vs DM 21%; NGT 5%). OWO was also associated with a higher CV risk (NW 3% vs OWO 10%). When IFG coexisted with OWO, the incidence of CV events further increased, with DM/OWO higher than in IFG/OWO (24% vs 15); in NGT/NW the incidence was 3%. A difference in CV events is checked between OWO and DM/OWO and between OWO and IFG/OWO. CONCLUSIONS Survival curves show that in both sexes OWO, IFG and DM show higher mortality than NW and NGT. Among patients with OWO, the concomitant presence of diabetes leads to an increased risk of events or death. The data also suggest that IFG patients would also need attention and possible treatment for risk prevention