Fasting Glucose Level and the Risk of Incident Atherosclerotic Cardiovascular Diseases

被引:116
作者
Park, Chanshin [1 ]
Guallar, Eliseo [2 ,3 ,4 ,5 ]
Linton, John A. [1 ,6 ]
Lee, Duk-Chul [6 ]
Jang, Yangsoo [7 ]
Son, Dong Koog [8 ]
Han, Eun-Jeong [8 ]
Baek, Soo Jin [8 ]
Yun, Young Duk [8 ]
Jee, Sun Ha [9 ,10 ]
Samet, Jonathan M. [11 ,12 ]
机构
[1] Severance Hosp, Int Hlth Care Ctr, Seoul, South Korea
[2] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Med, Baltimore, MD USA
[4] Johns Hopkins Bloomberg Sch Publ Hlth, Welch Ctr Prevent Epidemiol & Cardiovasc Res, Baltimore, MD USA
[5] Natl Ctr Cardiovasc Res CNIC, Dept Cardiovasc Epidemiol & Populat Genet, Madrid, Spain
[6] Yonsei Univ, Coll Med, Dept Family Med, Seoul 120749, South Korea
[7] Yonsei Univ, Severance Cardiovasc Hosp, Hlth Syst, Seoul 120749, South Korea
[8] Natl Hlth Insurance Serv, Seoul, South Korea
[9] Yonsei Univ, Grad Sch Publ Hlth, Inst Hlth Promot, Seoul 120749, South Korea
[10] Yonsei Univ, Grad Sch Publ Hlth, Dept Epidemiol & Hlth Promot, Seoul 120749, South Korea
[11] Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA 90033 USA
[12] Univ So Calif, Inst Global Hlth, Los Angeles, CA USA
基金
美国国家卫生研究院;
关键词
ALL-CAUSE MORTALITY; PLASMA-GLUCOSE; DIABETES-MELLITUS; VASCULAR-DISEASE; NONDIABETIC HYPERGLYCEMIA; CLINICAL CONSEQUENCES; MEDICAL THERAPY; LIFE-STYLE; KOREAN MEN; TOLERANCE;
D O I
10.2337/dc12-1577
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE-Although diabetes increases the risk of cardiovascular disease (CVD) and mortality, the dose-response relationship between fasting glucose levels below those diagnostic of diabetes with cardiovascular events has not been well characterized. RESEARCH DESIGN AND METHODS-A prospective cohort study of more than one million Koreans was conducted with a mean follow-up of 16 years. A total of 1,197,384 Korean adults with no specific medical conditions diagnosed were classified by baseline fasting serum glucose level. Associations of fasting glucose level with CVD incidence and mortality, stroke incidence and mortality, and all-cause mortality were analyzed using multivariate proportional hazards regression. RESULTS-The relationships between fasting glucose levels and CVD risks generally followed J-shape curves, with lowest risk in the glucose range of 85-99 mg/dL. As fasting glucose levels increased to >100 mg/dL, risks for CVD, ischemic heart disease, myocardial infarction, and thrombotic stroke progressively increased, but risk for hemorrhagic stroke did not. Fasting glucose levels <70 mg/dL were associated with increased risk of all stroke (hazard ratio 1.06, 95% CI 1.01-1.11) in men and (hazard ratio 1.11, 1.05-1.17) in women. CONCLUSIONS-Both low glucose level and impaired fasting glucose should be considered as predictors of risk for stroke and coronary heart disease. The fasting glucose level associated with the lowest cardiovascular risk may be in a narrow range.
引用
收藏
页码:1988 / 1993
页数:6
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