Atherosclerosis Risk Factors in Patients with Reactive Hypoglycemia

Abstract

Purpose

Glucose metabolism disorders are an established risk factor for atherosclerosis. Although reactive hypoglycemia (RH) can be classified as one of these disorders, its role as a potential atherosclerosis risk factor remains unclear. The aim of the study was to assess whether patients with RH have a higher risk of atherosclerosis.

Patients and Methods

We recruited 178 patients (N=178) with suspected RH who were hospitalized after 2014 and underwent a prolonged 5-hour oral glucose tolerance test. The study cohort was divided into 2 groups depending on the results of the oral glucose tolerance test: Group 1 – subjects without RH (n=44), Group 2 –subjects with RH (n=134).

Results

The analyzed groups differed significantly in terms of the following risk factors for atherosclerosis: high-density lipoprotein (HDL) cholesterol levels (54.3±18.8 mg/dL vs 63±18.5 mg/dL, p=0.003) and atherogenic indices (Castelli I: 3.7±1.2 vs 3.1±1.3, p=0.004; Castelli II: 2.1±0.9 vs 1.7±0.9, p=0.007; the atherogenic index of plasma: 0.34±0.33 vs 0.18±0.3, p=0.006; and the atherogenic coefficient: 2.7±1.2 vs 2.1±1.3, p=0.004). Univariate logistic regression showed that RH should not be considered to be a predictor of an increased atherogenic index of plasma (odds ratio [OR]=0.3 [95% confidence interval [CI] [0.16–0.7], p=0.002). Multivariate logistic regression revealed triglyceride levels (OR 1.14 [1.07–1.2], p=0.001) and body weight (OR 1.07 [1.03–1.12], p=0.002) to be independent risk factors for atherosclerosis.

Conclusion

Atherosclerosis risk factors are no more prevalent in patients with RH. RH does not increase the risk of an abnormal atherogenic index of plasma.

Keywords:

• postprandial hypoglycemia
• oral glucose tolerance test
• body weight
• cardiovascular risk
• triglycerides

Ethics Approval and Informed Consent

The study protocol, which follows the provisions of the Declaration of Helsinki, had been approved by The Bioethics Committee at the Medical University of Warsaw (approval No. KB/108/2021). It was agreed that due to the retrospective nature of the study the need for informed consent can be waived. Study participants’ data were anonymized. Due diligence was exercised to maintain the confidentiality of the medical records.

Acknowledgments

The study was supported by the Polish Ministry of Education and Science as part of the “Student science clubs create innovations” program.

Disclosure

Prof. Edward Franek MD PhD reports personal fees from Bayer, Boehringer Ingelheim, Novo Nordisk, Eli Lilly, and Servier, outside the submitted work. The authors report no other conflicts of interest in this work.

Additional information

Funding

Our research was funded by the Polish Ministry of Education and Science from state budget resources as part of the “Student science clubs create innovations” program [grant number: SKN/SP/496715/2021]. The sponsor was not involved in any of the stages of our study.