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asting Circulating lucose Levels in the on Diabetic Range Correlate ppropriately with any Components of the etabolic yndrome

by: Harry G. Preuss MD, Nate Mrvichin, Dallas Clouatre, Debasis Bagchi PhD, Jeffrey M. Preuss MD, Nicholas V. Perricone MD, Gilbert R Kaats PhD


Background: While the detriment to health of diabetes mellitus is universally accepted, a valid question arises whether milder, less obvious glucose-insulin disturbances contribute harm that may be overlooked. An answer is crucial, because the Western diet generates heavy sugar intake that has the potential to perturb glucose-insulin homeostasis and thus lay the groundwork for many chronic maladies.

Objective: We examined in non-diabetic individuals whether circulating glucose levels in the fasting state correlate adversely with various parameters, especially those associated with the metabolic syndrome, in order to establish if this measurement has the potential to predict general health at present and in the future.

Methods: We assessed baseline data from nearly 300 subjects volunteering for different clinical protocols. Only data from individuals with fasting glucose levels in the non-diabetic range (125 mg/dl) were included. Because the data were composed primarily of normally accepted clinical values, both correlations and quartile measurements were used to detect signicant alterations in health modalities.

Results: With fasting glucose in the non-diabetic range as the independent variable, the following correlations with components of the metabolic syndrome are statistically signicantly positive: body weight, body fat mass, systolic/diastolic BP, HbA1C, WBC/neutrophil count, and circulating levels of insulin, triglycerides, hsCRP, ALT, and globulins. In contrast, HDL-cholesterol correlates appropriately in a signicantly negative fashion. These ndings were corroborated when average values between the highest and lowest quartiles based on fasting glucose levels showed statistical differences consistent with the correlation results. Of further importance, the ndings also suggest that higher glucose levels are associated with augmented inammation and liver perturbations proposed to play a meaningful role in the metabolic syndrome. Unlike glucose, when total cholesterol became the independent variable, most risk factors showed improvement.


Conclusion: Fasting glucose levels even in the normal range could provide a guide for preventing, treating, and/ or ameliorating present and approaching major health problems. The ndings imply that maintaining fasting glucose at the lowest safe levels may afford the most healthful outlook.


Over recent years, many, often age-related, chronic health disturbances have become more widespread and even described as being epidemic. 1-7

association, the afore-mentioned maladies are commonly linked to one another as the metabolic syndrome. 1,2,8

Almost a century ago, two popular theories to explain increased prevalence of obesity, diabetes, and cardiovascular disorders like hypertension emerged.1,2

One explanation was based on the assumption that dietary intake of too much saturated fats creates damaging levels of circulating cholesterol and increases body fat mass9-11

rst theory received overwhelming general acceptance

and publicity despite some cogent arguments against it.17- 20

Few public warnings were offered concerning excess sugar consumption and its adverse effect on the glucose- insulin system. This oversight is now being corrected. 21-28

and an older report found increasing hemoglobin A1C (HbA1C) and insulin levels even in the non-diabetic range may affect blood pressure adversely.30

by these published studies, we reasoned that it would be fruitful to determine whether rising circulating glucose levels within the commonly accepted non-diabetic range by reecting imperfect glucose-insulin homeostasis such as minor insulin resistance predict early onset of many disturbed health parameters involved in the pathogenesis of the metabolic syndrome.

Accordingly, similar to previous studies associating circulating cholesterol levels with various health disorders, we set out to determine whether fasting levels of circulating glucose in the non-diabetic range correlate signicantly with harmful changes in body composition, blood pressure, blood chemistries, and/or blood cell counts. Because we worked exclusively with subjects possessing non-diabetic fasting glucose concentrations, the other measured clinical values, for the most part, fell in the accepted normal range. Therefore, correlations rather than exact numbers were largely used to determine alterations in health modalities. For corroboration, however, we

THE ORIGINAL INTERNIST JUNE 2016 (Continued on next page)


Recent ndings reported that higher concentrations of circulating glucose within range levels generally accepted as normal can inuence brain function in an unfavorable manner29

the other stressed that consumption of too much sugar reduces insulin sensitivity causing injury, at least in part, via elevated circulating levels of glucose and insulin and perturbed homeostatic mechanisms.12-16

At the time, the  .

awareness of their existence, the explanations behind the increased incidence of over-weight/obesity, glucose- insulin perturbations/type 2 diabetes, hypertension, and dyslipidemias such as hypertriglyceridemia and lowered levels of circulating HDL-cholesterol remains questionable to many.1,2

Because of their frequent In spite of general

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