Fasting glucose level and the risk of incident atherosclerotic cardiovascular diseases

Chanshin Park, Eliseo Guallar, John A. Linton, Duk Chul Lee, Yangsoo Jang, Dong Koog Son, Eun Jeong Han, Soo Jin Baek, Young Duk Yun, Sun Ha Jee, Jonathan M. Samet

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

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. ResultsThe 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.

Original languageEnglish
Pages (from-to)1988-1993
Number of pages6
JournalDiabetes Care
Volume36
Issue number7
DOIs
Publication statusPublished - 2013 Oct 28

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Fasting
Cardiovascular Diseases
Glucose
Stroke
Mortality
Incidence
Myocardial Ischemia
Coronary Disease
Cohort Studies
Research Design
Myocardial Infarction
Prospective Studies
Serum

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

Cite this

Park, C., Guallar, E., Linton, J. A., Lee, D. C., Jang, Y., Son, D. K., ... Samet, J. M. (2013). Fasting glucose level and the risk of incident atherosclerotic cardiovascular diseases. Diabetes Care, 36(7), 1988-1993. https://doi.org/10.2337/dc12-1577
Park, Chanshin ; Guallar, Eliseo ; Linton, John A. ; Lee, Duk Chul ; Jang, Yangsoo ; Son, Dong Koog ; Han, Eun Jeong ; Baek, Soo Jin ; Yun, Young Duk ; Jee, Sun Ha ; Samet, Jonathan M. / Fasting glucose level and the risk of incident atherosclerotic cardiovascular diseases. In: Diabetes Care. 2013 ; Vol. 36, No. 7. pp. 1988-1993.
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abstract = "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. ResultsThe 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.",
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Park, C, Guallar, E, Linton, JA, Lee, DC, Jang, Y, Son, DK, Han, EJ, Baek, SJ, Yun, YD, Jee, SH & Samet, JM 2013, 'Fasting glucose level and the risk of incident atherosclerotic cardiovascular diseases', Diabetes Care, vol. 36, no. 7, pp. 1988-1993. https://doi.org/10.2337/dc12-1577

Fasting glucose level and the risk of incident atherosclerotic cardiovascular diseases. / Park, Chanshin; Guallar, Eliseo; Linton, John A.; Lee, Duk Chul; Jang, Yangsoo; Son, Dong Koog; Han, Eun Jeong; Baek, Soo Jin; Yun, Young Duk; Jee, Sun Ha; Samet, Jonathan M.

In: Diabetes Care, Vol. 36, No. 7, 28.10.2013, p. 1988-1993.

Research output: Contribution to journalArticle

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T1 - Fasting glucose level and the risk of incident atherosclerotic cardiovascular diseases

AU - Park, Chanshin

AU - Guallar, Eliseo

AU - Linton, John A.

AU - Lee, Duk Chul

AU - Jang, Yangsoo

AU - Son, Dong Koog

AU - Han, Eun Jeong

AU - Baek, Soo Jin

AU - Yun, Young Duk

AU - Jee, Sun Ha

AU - Samet, Jonathan M.

PY - 2013/10/28

Y1 - 2013/10/28

N2 - 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. ResultsThe 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.

AB - 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. ResultsThe 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.

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