Prediabetes, particularly impaired fasting glucose (IFG), remains an important stage for diabetes prevention and early vascular risk assessment. A retrospective cohort study published in Frontiers in Endocrinology examined whether estimated pulse wave velocity (ePWV), a noninvasive marker of aortic stiffness, was associated with incident IFG in Chinese adults.

The analysis included 184,291 adults from the Rich Healthcare Group with normal baseline fasting plasma glucose. Participants were categorized into quartiles according to ePWV. Kaplan-Meier survival analysis, Cox proportional hazards models, restricted cubic spline analysis, and sensitivity and subgroup analyses were performed. Multivariable models adjusted for sex, body mass index (BMI), fasting plasma glucose, blood lipids, liver and renal function, and behavioral factors.

During a median follow-up of 3.0 years, 20,783 participants (11.28%) developed IFG. Each 1 m/s increase in ePWV was independently associated with higher IFG risk (hazard ratio [HR] 1.19; 95% confidence interval [CI] 1.18-1.20). Kaplan-Meier analysis showed progressively higher IFG incidence across increasing ePWV quartiles.

Restricted cubic spline analysis identified a nonlinear relationship with an inflection point at 8.365 m/s. Below this level, each 1 m/s increase in ePWV was associated with a 33% higher risk of IFG. Positive associations remained consistent across subgroup analyses. These findings suggest ePWV may help identify individuals at increased risk for future IFG using a simple noninvasive measure.