Abstract

Objective: To examine the association of hyperglycemia, as measured by GHb, with subsequent mortality in a nationally representative sample of adults.

Research Design and Methods: We included adults age 20 years and older who participated in Third National Health and Nutrition Examination Survey (1988-1994) and had complete information, including baseline diabetes status by self-report and measured GHb measured (n = 19,025) and follow-up through the end of 2000 for mortality.

Results: In the overall population, higher levels of GHb were associated with increased risk of mortality from all-causes, heart disease and cancer. After adjusting for potential risk factors, compared to adults with GHb < 6% the relative hazard (RH) for adults with GHb ≥ 8% was 2.59 (95% CI 1.88, 3.56) for all-cause mortality, 3.38 (95% CI 1.98, 5.77) for heart disease mortality and 2.64 (95% CI 1.17, 5.97) for cancer mortality. Among adults with diagnosed diabetes, having a GHb ≥ 8% as compared to GHb < 6% was associated with higher all-cause [RH 1.68 (95% CI 1.03, 2.74] and heart disease mortality [ RH 2.48 (95% CI 1.09, 5.64)] but there was no increased risk of cancer mortality by GHb category. Among adults without diagnosed diabetes, there was no significant association of all-cause, heart disease or cancer mortality and GHb category.

Conclusions: These results highlight the importance of GHb levels in mortality risk among a nationally representative sample of adults with and without diagnosed diabetes and indicate that higher levels are associated with increased mortality in adults with diabetes.