Metabolic and Cardiovascular Risk Assessment in Prediabetes: A Comparative Cross-Sectional Study with Type 2 Diabetes Mellitus and Healthy Controls

Abstract

Background: Prediabetes is an intermediate glycemic state linked with early metabolic abnormalities and increased cardiovascular risk, requiring timely detection and management.

Objective: This study aimed to assess the metabolic and cardiovascular risk profiles of individuals with prediabetes (Pre-D) compared with patients with type 2 diabetes mellitus (T2DM) and healthy controls, and to identify key predictors of cardiovascular risk associated with glycemic disturbances.

Methods: A comparative cross-sectional study was conducted at King Fahd Medical Complex, Riyadh, Saudi Arabia, from January 2024 to July 2024, involving 84 Pre-D, 95 T2DM, and 105 healthy individuals. Anthropometric, biochemical, and clinical parameters including fasting plasma glucose (FPG), HbA1c, insulin, lipid profile, body mass index (BMI), and blood pressure were measured. Insulin resistance was calculated using HOMA-IR. Statistical analysis was performed using SPSS version 28.0, with p < 0.05 considered significant.

Results: Prediabetic and T2DM groups exhibited significantly higher BMI, waist circumference, fat percentage, FPG, HbA1c, insulin, and triglycerides compared to controls (p < 0.001). Regression analysis revealed that BMI, FPG, fasting insulin, and HOMA-IR were independent predictors of prediabetes (p < 0.001). Cardiovascular risk analysis indicated higher odds ratios for hypertension (OR = 33.2), hyperglycemia (OR = 42.1), metabolic syndrome (OR = 36.7), smoking (OR = 52.4), and obesity (OR = 67.1) in prediabetic individuals.

Conclusion: Prediabetes is associated with significant metabolic derangements and increased cardiovascular risk even before diabetes onset. Early identification and management of metabolic abnormalities may mitigate progression to T2DM and prevent cardiovascular complications.