Les relations bien connues en cas d'hémochromatose entre surcharge en fer, insulinorésistance et stress oxydant, nous ont conduit à chercher à établir le rôle de la ferritine comme un facteur prédictif du risque de diabète gestationnel et du stress oxydant indépendamment de toute supplémentation dans une population de femmes Libanaises non anémiques. Nous avons observé qu'une ferritine élevée en début de la grossesse était un facteur prédictif d'intolérance au glucose, alors que cette relation n'était pas retrouvée avec une hémoglobine élevée, suggérant que le fer de réserve est un facteur de risque à considérer et non pas le fer fonctionnel. Le dosage de la ferritine pourrait être un marqueur biologique à prendre en considération pour évaluer le risque d'intolérance au glucose chez les femmes à risque de diabète gestationnel. La prévalence du diabète gestationnel dans la population étudiée, sur la base de nouveaux critères adoptés par l'Organisation mondiale de la santé était de ~15% alors qu'elle n'était que de 4% avec les critères de O'Sullivan actuellement utilisés dans les hôpitaux où a été recrutée notre population. Cette forte différence souligne la nécessité de l'adoption de nouveaux critères pour un meilleur dépistage et une meilleure prise en charge du fait des risques materno-fœtaux associés au diabète gestationnel. Malgré l'abaissement des valeurs de la glycémie, nous montrons que les nouveaux seuils de glycémie définissant désormais un diabète gestationnel sont toujours associés à une augmentation du stress oxydant, notamment des dommages à l'ADN. Conformément à la littérature, nous montrons qu'un statut en fer élevé, est associé à un état de stress oxydant élevé. De façon plus originale nous montrons qu'une ferritine élevée en début de grossesse aggrave l'association du stress oxydant et de l'insulinorésistance avec l'intolérance au glucose. En l`absence de modèle satisfaisant pour l`étude du diabète gestationnel expérimental, nous avons validé dans une étude préliminaire un régime riche en fructose comme modèle expérimental de diabète gestationnel. Nous montrons que ce modèle induit les mêmes modifications chez les rates et leurs ratons que celles observées lors de diabète gestationnel, de plus lorsque ce régime est enrichi en fer, des altérations oxydatives sont observées au niveau cérébral et hépatique des ratons. Ce modèle expérimental nous permettra d'étudier ultérieurement les voies de signalisation qui régissent les interactions entre fer, stress oxydant et diabète gestationnel et d'évaluer les répercussions d'une augmentation des dommages oxydatifs chez les fœtus, chez les nouveau-nés à la naissance et à distance par des études de comportement. Enfin en raison des données récentes sur l'épigénétique notre modèle expérimental pourrait nous permettre de suivre l'évolution en terme d'apparition de pathologies à l'âge adulte (insulinorésistance, diabète de type 2, déclin cognitif) des animaux nés de mère avec un diabète gestationnel. Au vu de l`ensemble de nos résultats sur les interactions entre ferritine, intolérance au glucose et stress oxydant, le bénéfice d`une supplémentation martiale durant la grossesse chez des femmes à risque de diabète gestationnel doit être évalué. / The overall goal of this study was to establish the role of ferritin as a predictor for gestational diabetes mellitus and oxidative stress in non-anemic and non-iron supplemented Lebanese women. We observed that high ferritin level during the first-trimester of pregnancy was a predictor for impaired glucose tolerance, whereas high hemoglobin values yielded no significant relationship, suggesting that the iron reserve was the main indicator to be considered as a risk factor rather than the functional iron. Thus, the serum ferritin level could be used as a biological marker to assess for the risk of glucose intolerance in pregnant women. Based on the new World Health Organization criteria for gestational diabetes mellitus diagnosis, it is predicted that gestational diabetes mellitus prevalence in our population could be increased by four-fold. Since gestational diabetes mellitus has deleterious effects on the perinatal and maternal health outcomes, the implementation of these new criteria will allow for better management of blood glucose in pregnant women at risk for developing gestational diabetes mellitus. Although the new criteria adopted lower cut-off blood glucose value, hyperglycemia is still a factor that highly associated with increase oxidative stress, ultimately leading to DNA damage. Previously, we have shown that high iron status was associated with elevated oxidative stress. Furthermore, we have established that high ferritin during early-term pregnancy affected the association between oxidative stress and insulin resistance with glucose intolerance. Due to the lack of good experimental model to study gestational diabetes mellitus, we have utilized fructose-supplemented diet fed pregnant dam as an experimental animal model for our gestational diabetes studies. Data obtained in a preliminary study indicated that, this experimental animal model had identical metabolic modifications found in women with gestational diabetes mellitus. Moreover, we have showed that iron-enriched diet significantly increased the redox status of the brain and the liver of the fructose-supplemented dams. Therefore, we believed that this experimental model is good model for future studies to evaluate the signaling pathways involved in iron, oxidative stress and gestational diabetes and to assess the impact of increased oxidative damage during pregnancy on the fetus, immediately after birth and later during the developmental stages via various behavioral tests. Finally, an epigenetic study using this experimental model may allow us to understand the genetic alterations that affected the likelihood of developing insulin resistance, diabetes, or cognitive decline in pups born to the mothers with gestational diabetes. Based on the findings from our studies on the interaction between ferritin, glucose impairment, and oxidative stress, as well as the iron-supplemented diet in the dams with gestational diabetes mellitus, a caution must be exercised when supplementing a pregnant woman with iron. The use of iron-supplementation during pregnancy should be re-evaluated.

Introduction: Physical activity should be part of our everyday life. However, for people with Type 1 Diabetes Mellitus it is the most common cause of hypoglycemia. To control diabetes in the right way, it is therefore necessary to follow certain rules and recommendations that help preventing hypoglycemia while the physical activity remains beneficial at the same time. Aim of the work: The main aim of this study is to clarify the influence of physical activity in connection to long-term control of Type 1 Diabetes Mellitus. Methods: 102 respondents with diagnosed Type 1 Diabetes Mellitus in the age of 19-69 years participated in a quantitative analysis. This research was conducted in a form of multicentric examination at two independent medical centers. The data collection was done through questionnaires focused on physical activity and daily regime. The data from questionnaires were then compared to the values of glycated hemoglobin (HbA1C), HDL cholesterol and the total daily dose of insulin of certain patients. For statistical evaluation, analytical tools of Microsoft Office program were used (F-test and t-test). Results: We found correlation between HbA1C values in patients physically active for less than 2 hours/week compared to those who are physically active for more than 2 hours/week (62,72...

Pães integrais são alimentos de consumo habitual da população brasileira, porém há poucas informações a respeito da resposta glicêmica pós-prandial, O presente trabalho teve como objetivo avaliar a resposta glicêmica produzida, em indivíduos saudáveis, após o consumo de pães de fôrma rotulados como integrais. Oito pães de fôrma integrais de três categorias (clássico, light e com grãos) foram avaliados, após o consumo de porcão equivalente a 25 g de carboidratos disponíveis, através do índice glicêmico (IG) e carga glicêmica (CG). Os voluntários (n=15) compareceram ao laboratório em jejum (10 a 12 horas), pela manhã, em onze ocasiões (três dias para o consumo do pão controle e um dia para cada tipo de pão de fôrma integral). A glicemia foi determinada em jejum (t=0) e após o consumo de cada pão nos tempos: 15; 30; 45; 60; 90 e 120 minutos. A curva de resposta glicêmica, a área sob a curva (ASC) e o cálculo do IG e CG para cada um dos pães foram realizados. Considerando a glicose como referência, os pães integrais clássicos (n=2) apresentaram alto IG (71 %); os light (n=2), IG baixo (50 %) e médio (58 %) e; os com grãos (n=4), IG baixo (44 e 49 %) e médio (57 e 60 %). Os pães de fôrma light e com grãos apresentaram IG menor que os do tipo clássico (p<0,05), os quais apresentaram IG igual ao pão francês (controle). Como foi consumida a mesma quantidade de carboidratos disponíveis, a menor proporção de açúcar solúvel na categoria light parece ter sido o fator que induziu ao menor IG observado. Em relação à CG, um pão de fôrma integral light (CG=10) e outro com grãos (CG=7) foram classificados como baixa CG; os demais pães integrais (n=6) foram classificados como média CG (11 a 16). Todos os pães integrais apresentaram CG inferior a do pão controle (CG=18) (p<0,05) e entre os integrais novamente os da categoria light e com grãos foram os que apresentaram menor CG. Assim, foi observada variação na resposta glicêmica após o consumo de pães de fôrma integrais, sendo que a redução no conteúdo de açúcares solúveis, para os pães light, e a adição de grãos integrais, nos pães com grãos, favoreceram menor elevação da resposta glicêmica pós-prandial. / Whole meal breads are part of the habitual daily diet of the Brazilian population, but there is little information on the postprandial glycaemic response. The aim of this work was to evaluate the glycaemic response produced, in healthy volunteers, following the consumption of breads labeled as whole meal. Eight whole meal breads of three different categories (classic, light and grains) were evaluated, after the consumption of a portion containing approximately 25 g of available carbohydrates, using the glycaemic index (GI) and glycaemic load (GL). The subjects (n=15) attended to the laboratory after an overnight fasting (10 to 12 hours), in eleven different occasions (three days for the consumption of the control bread and a day for each whole meal bread). In every occasion, a portion of bread containing 25 g of available carbohydrate was consumed. Capillary blood samples were taken immediately before (t=0) and 15, 30, 45, 60, 90 and 120 minutes after the consumption of test breads. The glycaemic response curve, area under the curve (AUC), GI and GL for each bread were obtained. Considering glucose as reference, the classic breads (n=2) had high GI (71 %); the light (n=2), low (50 %) and medium (58 %) GI; and grains (n=4), low (44 and 49 %) and medium (57 and 60 %) GI. The light and grain breads had lower GI than the classic (p<0,05), which presented GI similar to white bread (control). As the same amount of available carbohydrates was consumed, the reduced proportion of soluble sugars in the light category breads seems to be a factor that induced the lower GI observed. In relation to the GL, one light bread (GL=10) and a grain bread (GL=7) were classified as low GL; the other whole meal breads (n=6) were classified as medium GL (11 to 16). All whole meal breads had lower GL than the control bread (GL=18) (p<0,05), and among the whole meal breads the ones in both light and grain categories presented the lower GL. Therefore, it was possible to observe variation on the glycaemic responses following the consumption of whole meal breads, the reduction in soluble sugar content, in the light breads, and the addition of whole grains, in the grain breads, favored lower elevation in the postprandial glycaemic response.

In my thesis I dealt with the theme of very serious and widespread diseases of civilization posed by diabetes mellitus (diabetes), type 2. Incidence of the disease is considered a pandemic of the 21st century. I focused on macro- and microvascular complications of type 2 diabetes mellitus. The work is divided into two parts. The theoretical part deals with the description of type 2 diabetes in terms of its origin, course, diagnosis and treatment, including komplkací. In the practical part I am devoted to a survey of diabetic patients in the waiting rooms of several diabetics. Through the questionnaire, I investigated how respondents have access to their disease. Whether they know their blood glucose levels as they are treated, whether they realize the seriousness of their illness if they have already expressed complications of diabetes and how to approach the treatment, if observe regime measures. The respondents' answers, I analyzed and processed using graphs.

Fundação de Apoio a Pesquisa e à Inovação Tecnológica do Estado de Sergipe - FAPITEC/SE / The author of the present work aimed at evaluating the influence of the inclusion of soybean hull (SH) upon the apparent digestibility, the physical-chemical characteristics of feces and the postprandial glycemic responses of horses submitted to moderate-intensity exercise. Five horses were used, aging 11 +2 years old and weighing 483 ± 18 kg. The diets consisted of 60% of Tifton 85 hay (Cynodon spp) and 40% of a pelletized commercial concentrate. The treatments were: substitution of the concentrate for 0%, 10%, 20%, 30% and 40% of SH (Kg/Kg). The experimental period lasted 50 days, being 5 ten-day periods: 7 days for the adaptation to the diet and 3 days of total feces collection. Bromatological analyses of both the foods and of the feces samples were performed for the determination of the apparent digestibility coefficients of the nutrients. The evaluation of the characteristics of the feces comprehended consistency, coloration and pH. For the glycemic tests, 5 mL of blood was collected around 30 minutes before, and 30, 60, 90, 120, 180, 240 and 300 minutes after the administration of the soybean hull homogenized to the concentrate. The experimental delineation used was entirely casualized in Latin square (5x5). For the statistical analyses, the data were submitted to variance analysis. The means were compared with Tukey´s test at 5% of significance. The result demonstrated that there were no effects (P>0.05) of the substitution levels of the concentrate for the soybean hull over the apparent digestibility coefficient of dry matter, organic matter, crude protein, ether extract, nonstructural carbohydrates, hemicellulose, rapidly fermented carbohydrate and energy. However, significant statistical differences were observed (P<0.05) for the apparent digestibility coefficient acid detergent fiber and slowly fermented carbohydrate, with better results for the 30% and 40% substitution levels and a drop in hydrolysable carbohydrate at the 40% level of substitution. Regarding the consistency and coloration, 100% of the horses produced normal (score 3) green-colored feces. There were no statistical differences for the pH value, with means of 6.34. The glucose peak and the area below the glycemic curve were not influenced (P<0.05) by the increasing levels of soybean hull in the diet. It is concluded that the soybean hull can be replaced in 30% and 40%, thus allowing the increase in the apparent digestibility of the fibrous fraction, without causing alterations to the physical-chemical characteristics of both the feces and the glycemic responses of horses undergoing moderate-intensity exercises. / O objetivo da autora deste trabalho foi avaliar a influência da inclusão de casca de soja (CS) na digestibilidade aparente, características físico-químicas das fezes e resposta glicêmicas pós-prandial de equinos submetidos a exercício de intensidade moderada. Foram utilizados cinco equinos com idade de 11 +2 anos e peso médio de 455 ± 23 kg. Os tratamentos foram: substituição do concentrado por 0%, 10%, 20%, 30% e 40% de CS (Kg/Kg). O período experimental teve duração de 50 dias, divididos em cinco períodos de 10 dias cada, sendo 7 dias de adaptação à dieta e 3 dias de coleta total de fezes. Realizou-se análises bromatológicas dos alimentos e das amostras compostas de fezes para estimar os coeficientes de digestibilidade aparente dos nutrientes. As avaliações das características das fezes compreenderam consistência, coloração e pH. Para o teste glicêmico foram coletados 5 mL de sangue cerca de 30 minutos antes, 30, 60, 90, 120, 180, 240 e 300 minutos após administração da casca de soja homogeneizada ao concentrado. O delineamento experimental foi inteiramente casualizado em quadrado latino (5x5). Os dados foram submetidos à analise de variância e as médias comparadas pelo teste Tukey a 5% de significância. Os resultados demostraram que não houve efeitos (P>0,05) dos níveis de substituições do concentrado pela casca de soja sobre os coeficientes de digestibilidade aparente da matéria seca, matéria orgânica, proteína bruta, extrato etéreo, carboidratos não estruturais, hemicelulose, energia bruta e carboidratos rapidamente fermentáveis; porém, observaram-se diferenças estatísticas significativas (P<0,05) para os coeficientes de digestibilidade aparente da fibra em detergente ácido e carboidratos lentamente fermentáveis, com aumento para os níveis de 30% e 40% de substituição e queda no coeficiente de digestibilidade aparente dos carboidratos hidrolisáveis ao nível de 40% de substituição Quanto à consistência e coloração, 100% dos equinos apresentaram fezes normal (escore 3) e esverdeada. Não houve diferenças estatísticas para o valor de pH com média de 6,34. O pico de glicose, tempo de pico e área abaixo da curva glicêmica não foram influenciados (P<0,05) pelos níveis crescentes de casca de soja na dieta. Conclui-se que a casca de soja pode ser substituída em 30% e 40% proporcionando aumento na digestibilidade aparente da fração fibrosa, sem causar alterações nas características físico-químicas das fezes e nas respostas glicêmicas de equinos submetidos a exercício moderado.

Contexte théorique : L’encéphalopathie hypoxique ischémique (EHI) est une condition du nouveau-né dans laquelle les mécanismes des variables métaboliques ne sont pas totalement compris. Cette population est particulièrement à risque d’hypo- ou d’hyperglycémie néonatales (HHN). Devant le manque de données sur le fonctionnement métabolique à la suite d’une EHI, cette étude vise à déterminer l’association entre une HHN et l’activité cérébrale mesurée par électroencéphalographie (EEG). Méthodologie : 49 participants avec EHI ont été recrutés au CHU Sainte-Justine peu après leur naissance. Ils ont été monitorés en continu à l’aide de l’EEG et des segments d’intérêt se retrouvant dans les 48 premières heures de vie ont été analysés. L’anormalité de l’activité cérébrale est déterminée selon une analyse quantitative du niveau de discontinuité caractérisée par une proportion de faibles amplitudes (seuils de 25, 15, 12,5, 10 et 7,5 uV) dans le tracé EEG. Les données de glycémie ont été recueillies de façon intermittente par le biais de prises de sang et de glucomètres de chevet. Les participants ont été répartis en 4 groupes : normoglycémie, hyperglycémie, hypoglycémie et glycémie variable (hypo- et hyper-). Résultats : L’analyse de covariation non -paramétrique a relevé une différence significative entre les ratios de discontinuité pour le seuil de 15 uV (F = 3,070 p = 0,037). Les analyses de comparaisons appariées ont montré une différence positive entre le groupe VARIABLE et le groupe contrôle (NORMO-) pour tous les seuils ainsi qu’une différence positive entre le groupe HYPER- et le groupe contrôle pour 4 des 5 seuils (25, 15, 12,5 et 7,5 uV). Aucune différence n’a été relevé entre le groupe HYPO- et le groupe contrôle pour tous les seuils. Conclusions : La variabilité glycémique et l’hyperglycémie seule ont été montrées comme étant associées à une activité cérébrale altérée caractérisée par un tracé de plus faible amplitude mesurée avec l’EEG. / Background: Hypoxic ischemic encephalopathy (HIE) is a newborn condition in which the underlying mechanisms still require further understanding. This clinical population is particularly prone to neonatal hypo- and hyperglycemia (NHH). Given the need to improve our understanding of metabolic functioning following HIE, this study aims to determine the association of NHH on the brain’s background electrophysiological activity measured by electroencephalography (EEG). Methodology: Forty-nine newborns with HIE were recruited at Sainte-Justine University Hospital Center. Continuous EEG monitoring was started as soon as possible and segments of interest in the first 48h of life were analyzed. Brain activity was quantitatively assessed according to an index of discontinuity characterized by the proportion of low EEG amplitudes per segment (< 25, 15, 12.5, 10 and 7.5 uV cutoffs). Glucose measurements were intermittently collected using blood samples and bedside glucometers and were retrospectively retrieved from medical charts. Participants were separated in 4 groups : normoglycemia, hyperglycemia, hypoglycemia and both (hyper- and hypo-). Results: The non-parametric covariance analyses revealed a significant difference between the discontinuity index for the 15 uV threshold (F = 3.070 p = 0.037). The pairwise comparisons showed a positive difference between the group BOTH and the control group (NORMO-) for every thresholds, the labile glucose group having a higher discontinuity index. A similar difference was found between the HYPERGLYCEMIA group and the control group for 4 out 5 thresholds (25, 15, 12.5 and 7.5 uV). No difference was found between the HYPOGLYCEMIA group and the control group. Conclusion: An abnormal glycemic profile, particularly glucose lability and hyperglycemia alone, were shown to be associated with abnormal brain activity characterized by a higher discontinuity index on the EEG.

ABSTRACT Influence of fenugreek gum on bread and in vitro physiological effects Keisha T. Roberts Advisors: University of Guelph Dr. S.W. Cui Professor T.E. Graham This thesis examined the effect of fenugreek gum, from Canadian grown fenugreek on bread quality, when substituted for wheat flour at 5 % and 10 %, and the in vitro physiological effects of these breads, based on models of acute and long - term feeding. Study I determined bread could be produced with 10 % fenugreek gum, while maintaining quality parameters of volume and texture, comparable to a control. This was accomplished through the development of a novel bread production method, using the lamination procedure for puff pastry production. The behavior of fenugreek gum and starch (wheat flour) was determined by rapid visco analysis (RVA), farinograph and dynamic rheological measurement, while scanning electron microscopy of bread found fenugreek gum could be identified within the bread matrix. Study 2 in vitro starch digestion found fenugreek gum at 5 % and 10 % reduced glucose liberated from bread, with 10 % fenugreek gum causing a reduction of over 30 %. RVA of fenugreek breads highlighted differences in viscosity between breads and wheat flour substituted with the gum. This was substantial as viscosity measurements by RVA are conducted on raw ingredients and not the food as consumed, which reflects the possible reduction in viscosity with food processing. This study also determined extruding fenugreek gum may have caused morphological changes to the gum, which may possibly contribute to attenuation of glucose liberated in vitro. Study 3 evaluated the accumulation of short chain fatty acids (SCFA) from the fermentation of three substrates: Extruded fenugreek gum, bread with 10 % extruded gum and control bread, based on fecal microbiota from three donors. SCFA profiles varied with substrates and donors, with fenugreek gum having the highest accumulation of SCFA after 12 hours. Donors were a caucuasian Canadian, a black Jamaican and a black Trinidadian who was the only donor culturally exposed to fenugreek. This Trinidadian’s SCFA profiles were consistently higher for fenugreek gum than the other donors. These studies collectively showed fenugreek gum, though viscous could be successfully incorporated into bread and have potential as a functional food and nutraceutical.

No description available.

The topic of the diploma thesis is the influence of a low-carbohydrate diet on the treatment of type 1 diabetes mellitus. It is an autoimmune disease for which it is necessary for patients to administer insulin. The selection of suitable sports activities, good health and mental condition and, above all, the adjustment of eating habits also contribute to the successful compensation of diabetes. This work demonstrates a low-carbohydrate diet as one of the possibilities diabetics can eat. The work is divided into two parts, theoretical and practical. The theoretical part briefly describes the disease and presents the recommended and a low- carbohydrate diet. The following section also addresses physical activity. It describes the issues of sports for people with diabetes who are on a regular diet, as well as on low-carbohydrate diet. The practical part shows the results of glucose sensors (Free Style Libre, Dexcom G6 and Medtronic), which continuously measure blood sugar levels. In the practical part, eight respondents with type 1 diabetes, who switched the recommended diet for a low-carbohydrate diet, were surveyed in the form of a questionnaire. The purpose of the questionnaire was to assess the effects of switching to a low- carbohydrate diet on: the compensation of diabetes; the frequency of...

Introdução: Glicemia de jejum alterada tem sido associada a maior risco de desenvolver diabetes, comparando a indivíduos normoglicêmicos. Apesar de diabetes ser relacionado a aterosclerose e a piores desfechos cardiovasculares, os dados de literatura relacionando glicemia de jejum alterada à doença aterosclerótica são conflitantes. Os objetivos deste trabalho foram determinar (a) a incidência de diabetes em indivíduos com glicemia de jejum normal ou alterada em 1998 após um seguimento de até 12 anos; (b) se a glicemia de jejum alterada em 1998 e/ou diabetes incidente estiveram associados com aterosclerose subclínica no Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) ou à variável combinada de eventos clínicos não-fatais e escore de cálcio coronariano maior ou igual a 400. Métodos: Avaliamos 1.536 trabalhadores da Universidade de São Paulo, que participaram de um programa de avaliação em 1998 (idade 23-63 anos) e da linha de base do ELSA-Brasil (2008-2010). Apresentamos as taxas de incidência de diabetes brutas e ajustadas para todos os indivíduos e também estratificados por gênero e por índice de massa corpórea (IMC) em 1998. Utilizamos modelos de regressão brutos e ajustados para estimar a associação entre glicemia de jejum alterada em 1998 ou diabetes incidente com a espessura de íntima-média de carótidas (EIMC), escore de cálcio coronariano (CACS, do inglês Coronary Artery Calcium Score) e a variável composta CACS >= 400 ou eventos cardiovasculares incidentes (infarto do miocárdio ou revascularização). Resultados: Encontramos diabetes incidente em 177 indivíduos. A incidência de diabetes em nossa amostra foi de 9,8/1.000 pessoas-ano (Intervalo de confiança de 95% [IC95%]: 7,7-13,6). A incidência foi mais elevada entre os homens (11,2/1.000 pessoas-ano, IC95%: 8,6-15,0) do que entre as mulheres (8,5/1.000 pessoas-ano, IC95%: 5,3-15,3). Glicemia de jejum alterada em 1998 mostrou associação com maior risco de progressão para diabetes ao longo do seguimento (hazard ratio [HR]: 3,17; IC95%: 2,14-4,68) e HR: 7,42; IC95%: 4,75-11,57 para glicemias de jejum entre 100 e 109mg/dl e entre 110 e 125mg/dl, respectivamente). Glicemias entre 110 e 125mg/dl em 1998 foram associadas a maiores valores de EIMC (beta=+0,028; IC95%: 0,003 a 0,053) na linha de base do ELSA-Brasil. Ao excluir da análise aqueles com diabetes incidente, houve associação limítrofe, não-significativa, entre maiores valores de EIMC e glicemia de jejum entre 110 e 125mg/dl em 1998 (?=0,030; IC95%: -0,005 a 0,065). Ambos os níveis de glicemia de jejum alterada em 1998 não se mostraram associados ao CACS ou à variável composta de CACS >= 400 ou eventos cardiovasculares incidentes nos modelos de ajuste completo. Diabetes incidente foi associado a maiores valores de EIMC (em milímetros) (?=0,034; IC95%: 0,015 a 0,053), a CACS >= 400 (Razão de chances=2,84; IC95%: 1,17-6,91) e ao desfecho combinado de CACS >= 400 ou eventos cardiovasculares incidentes (Razão de chances=3,50; IC95%: 1,60-7,65). Conclusões: Glicemia de jejum alterada em 1998, especialmente nos valores mais próximos dos limiares de corte para diabetes, foram associados a maior incidência de diabetes ao longo do seguimento e a maiores valores de EIMC quando da avaliação inicial do ELSA-Brasil. Diabetes incidente entre as avaliações foi associado a maior risco cardiovascular / Introduction: Impaired fasting glucose has been associated with higher risk of incident diabetes, compared to normoglycemic individuals. Although diabetes mellitus is related to atherosclerosis and higher long-term cardiovascular burden, there are conflicting data about the association between impaired fasting glucose and atherosclerotic disease. We aimed (a) to determine diabetes incidence rates in individuals with normal or impaired fasting glucose in 1998 after follow-up of up to 12 years, (b) whether impaired fasting glucose in 1998 and/or incident diabetes were associated with subclinical atherosclerosis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) or the combined variable of non-fatal clinical events or a coronary calcium score >= 400. Methods: We evaluated 1,536 civil servants from the University of São Paulo, who participated in both 1998 (aged 23-63 years) and ELSA-Brasil baseline (2008-2010) assessments and had complete data. We presented crude and adjusted diabetes incident rates for all individuals and then stratified by sex and body mass index (BMI) in 1998. We used crude and adjusted regression models to estimate the association between impaired fasting glucose in 1998 or incident diabetes and coronary intima-media thickness (CIMT), coronary artery calcium score (CACS) and the composite variable of a CACS?400 or incident cardiovascular events (myocardial infarction or revascularization). Results: We found incident diabetes in 177 individuals. Diabetes incidence in our sample was 9.8/1,000 person-years (95% confidence interval [95%CI]:7.7-13.6). Diabetes incidence was higher in men (11.2/1,000 person-years, 95%CI: 8.6-15.0) than women (8.5/1,000 person-years, 95%CI: 5.3 to 15.3). Impaired fasting glucose in 1998 was associated with a higher risk of progression to diabetes during follow-up (hazard ratio [HR]: 3.17; 95%CI: 2.14-4.68 and HR: 7.42; 95%CI: 4.75-11.57 for a fasting plasma glucose between 100 to 109mg/dl and 110 to 125 mg/dl, respectively). Fasting plasma glucose levels between 110 to 125 mg/dl in 1998 were associated with higher CIMT (beta=+0.028; 95%CI: 0.003 to 0.053) in ELSA-Brasil baseline. Excluding those with incident diabetes, there was a non-significant borderline association between higher CIMT (in mm) and fasting plasma glucose 110 to 125mg/dl (beta=0.030; 95%CI: -0.005 to 0.065). Fasting plasma glucose levels in 1998 were not associated with CACS or the composite variable of a CACS ? 400 or incident cardiovascular events in full-adjusted models. Incident diabetes was associated with higher CIMT (in mm) (beta=0.034; 95%CI: 0.015 to 0.053), CACS >= 400 (OR=2.84; 95%CI: 1.17-6.91) and the combined outcome of a CACS >= 400 or incident cardiovascular event (OR=3.50; 95%CI: 1.60-7.65). Conclusions: Elevated fasting plasma glucose in 1998, especially those near diabetes diagnosis limits were associated with higher diabetes incidence during follow-up and higher CIMT in ELSA-Brasil baseline assessment. Incident diabetes between assessments was associated with higher cardiovascular burden