Time in target range of fasting blood glucose ranges defined by WHO and ADA guidelines and cardiorenal Risk: Insights from two cohorts

Aims: Through the utilization of the time in target range (TTR), our study aims to reassess the differential risks of cardiorenal diseases associated with inconsistent pre-diabetes criteria, as defined by the World Health Organization (WHO) and the American Diabetes Association (ADA). Methods: We performed a pooled analysis from the Atherosclerosis Risk in Communities study and the Multi-Ethnic Study of Atherosclerosis study. TTR for each patient was calculated using linear interpolation before the outcome. Cox regression models were used to assess the association of fasting plasma glucose (FPG) TTR with the clinical outcomes. Results: A total of 14,346 patients were included. Using adjusted Cox regression model, both ADA (HR: 1.17, 95 % CI: 1.09 to 1.25) and WHO (HR: 1.37, 95 % CI: 1.21 to 1.57) defined pre-diabetes range were associated with an increased risk of major adverse cardiovascular events (MACE). Additionally, individuals with FPG levels in the range between the two standards (100–110 mg/dL) also had a higher risk of MACE (HR: 1.24, 95 % CI: 1.09 to 1.40). Meanwhile, no significant relation was found between FPG threshold and Chronic kidney disease (CKD). Conclusions: The threshold defined by the ADA guidelines serves to protect cardiovascular health across a broader population while not increasing the risk of CKD.