High body adiposity drives glucose intolerance and increases cardiovascular risk in normoglycemic subjects

Objective: We aimed to assess the utility of the 2 - hour oral glucose tolerance test (OGTT) value to discriminate between different cardiometabolic profiles and examine the role of body composition to predict the associated increased risk for glucose impairment, beta cell dysfunction and cardiovascular disease. Methods: Subjects with normal fasting glucose (NFG) completed a 2 - h OGTT and were categorized to the carbohydrate metabolism alterations (CMA) or contro l group based upon a 2 - h glucose threshold of 7.8 mmol l - 1 . Body composition, visceral adipose tissue, OGTT - based parameters and cardiovascular risk factors (CVRF) such as hypertension, dyslipidemia, obstructive sleep apnea, non - alcoholic fatty liver disea se and smoking status, were measured. Results: Subjects with CMA exhibited a significantly higher 1 - h postload glucose, greater decline in beta cell function and CVRF profile. After multivariate adjustment, excess of total body and visceral fat was associ ated with an increased risk of CMA, - cell dysfunction, CVRF and a lower whole - body insulin sensitivity. Conclusions: These data support the ethiopathogenic role of body and visceral fat in the development of glucose derangements and CVRF early on in the metabolic dysregulation process. Thus, body composition analysis and OGTT assessment performed in individuals with NFG enables a better identification of patients at risk of developing type 2 diabetes and cardiovascular disease