Abstract

Detailed pathophysiological manifestations of early disease in the context of prediabetes are poorly understood. This study aimed to evaluate the extent of early signs of cardiovascular complications affecting multiple organs in individuals with prediabetes. Subjects without prior history of stroke, coronary or peripheral artery disease were enrolled in a case-control study nested within the Cooperative Health Research in the Region of Augsburg (KORA) FF4 cohort and underwent comprehensive MR imaging assessment to characterize cerebral, (white matter lesions, microbleeds), cardiovascular (carotid plaque, left ventricular function and myocardial late gadolinium enhancement [LGE]), and metabolic parameters (hepatic proton-density-fat-fraction [PDFF] and subcutaneous and visceral adipose tissue). Among 400 subjects who underwent MRI, 103 subjects had prediabetes and 54 established diabetes. Subjects with prediabetes had an increased risk for carotid plaque and adverse functional cardiac parameters, including reduced early diastolic filling rates as well as a higher prevalence of LGE as compared to healthy controls. In addition, people with prediabetes had significantly elevated levels of PDFF and total and visceral adipose tissue. Thus, subjects with prediabetes show early signs of subclinical disease that include vascular, cardiac, and metabolic changes as measured by whole-body MRI after adjusting for cardiometabolic risk factors.