Cardiovascular Disease Mortality in Europeans in Relation to Fasting and 2-h Plasma Glucose Levels Within a Normoglycemic Range
- Feng Ning, MS1,
- Jaakko Tuomilehto, MD, PHD1,2,
- Kalevi Pyörälä, MD, PHD3,
- Altan Onat, MD, PHD4,5,
- Stefan Söderberg, MD, PHD6,7,
- Qing Qiao, MD, PHD1,2 and
- for the DECODE Study Group*
- 1Department of Public Health, University of Helsinki, Helsinki, Finland;
- 2Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland;
- 3Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland;
- 4Turkish Society of Cardiology, Istanbul, Turkey;
- 5Department of Cardiology, Cerrahpaçsa Medical Faculty, Istanbul University, Istanbul, Turkey;
- 6Department of Public Health and Clinical Medicine, Cardiology, Umeå University Hospital, Umeå, Sweden;
- 7Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
- Corresponding author: Qing Qiao, qing.qiao{at}helsinki.fi.
Abstract
OBJECTIVE To study mortality in relation to fasting plasma glucose (FPG) and 2-h plasma glucose levels within the normoglycemic range.
RESEARCH DESIGN AND METHODS Data from 19 European cohorts comprising 12,566 men and 10,874 women who had FPG <6.1 mmol/l and 2-h plasma glucose <7.8 mmol/l at baseline examination were analyzed. Multivariate-adjusted hazard ratios (HRs) and 95% CIs for deaths from cardiovascular disease (CVD), non-CVD, and all causes were estimated for individuals whose 2-h plasma glucose > FPG (group II) compared with those whose 2-h plasma glucose ≤ FPG (group I).
RESULTS A total of 827 (246) CVD and 611 (351) non-CVD and 1,438 (597) all-cause deaths occurred in men (women). Group II was older and had higher BMI, blood pressure, and fasting insulin than group I. The multivariate-adjusted HRs (95% CIs) for CVD, non-CVD, and all-cause mortality were 1.22 (1.05–1.41), 1.09 (0.92–1.29), and 1.16 (1.04–1.30) in men and 1.40 (1.03–1.89), 0.99 (0.79–1.25), and 1.13 (0.94–1.35) in women, respectively, for group II as compared with group I. HRs were 1.25 (1.05–1.50), 1.09 (0.89–1.34), and 1.18 (1.03–1.35) in men and 1.60 (1.03–2.48), 1.05 (0.78–1.42), and 1.18 (0.93–1.51) in women, respectively, after additional adjustment for fasting insulin in a subgroup of individuals.
CONCLUSIONS In individuals with both FPG and 2-h plasma glucose within the normoglycemic range, high 2-h plasma glucose was associated with insulin resistance and increased CVD mortality.
Footnotes
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↵*A complete list of the participating investigators in the Diabetes Epidemiology: Collaborative Analysis of Diagnostic Criteria in Europe (DECODE) Study Group can be found in the online appendix, available at http://care.diabetesjournals.org/cgi/content/full/dc09-2328/DC1.
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- Received December 21, 2009.
- Accepted April 20, 2010.
- © 2010 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
