Prospective Study of Fasting Blood Glucose and Intracerebral Hemorrhagic Risk.

Abstract

BACKGROUND AND PURPOSE:

Although diabetes mellitus is an established independent risk factor for ischemic stroke, the association between fasting blood glucose and intracerebral hemorrhage (ICH) is limited and inconsistent. The objective of the current study was to examine the potential impact of long-term fasting blood glucose concentration on subsequent risk of ICH.

METHODS:

This prospective study included 96 110 participants of the Kailuan study, living in Kailuan community, Tangshan city, China, who were free of cardiovascular diseases and cancer at baseline (2006). Fasting blood glucose concentration was measured in 2006, 2008, 2010, and 2012. Updated cumulative average fasting blood glucose concentration was used as primary exposure of the current study. Incident ICH from 2006 to 2015 was confirmed by review of medical records.

RESULTS:

During 817 531 person-years of follow-up, we identified 755 incident ICH cases. The nadir risk of ICH was observed at fasting blood glucose concentration of 5.3 mmol/L. The adjusted hazard ratios and their 95% confidence intervals (CIs) of ICH were 1.59 (95% CI, 1.26-2.02) for diabetes mellitus or fasting blood glucose ≥7.00 mmol/L, 1.31 (95% CI, 1.02-1.69) for impaired fasting blood glucose (fasting blood glucose, 6.10-6.99 mmol/L), 0.98 (95% CI, 0.78-1.22) for fasting blood glucose 5.60 to 6.09 mmol/L, and 2.04 (95% CI, 1.23-3.38) for hypoglycemia (fasting blood glucose, <4.00 mmol/L), comparing with normal fasting blood glucose 4.00 to 5.59 mmol/L. The results persisted after excluding individuals who used hypoglycemic, aspirin, antihypertensive agents, or anticoagulants, and those with intracerebral hemorrhagic cases occurred in the first 2 years of follow-up.

CONCLUSIONS:

In this large community-based cohort, low (<4.0 mmol/L) and high (≥6.1 mmol/L) fasting blood glucose concentrations were associated with higher risk of incident ICH, relative to fasting blood glucose concentrations of 4.00 to 6.09 mmol/L.

• Authors: Cheng Jin, Guohong Li, Kathryn M Rexrode, Mahmut E Gurol, Xiaodong Yuan, Ying Hui, Chunyu Ruan, Anand Vaidya, Yanxiu Wang, Shouling Wu, Xiang Gao
• Journal: Stroke (Stroke) Vol. 49 Issue 1 Pg. 27-33 (01 2018) ISSN: 1524-4628 [Electronic] United States
• PMID: 29229723 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2017 American Heart Association, Inc.

Chemical References

• Blood Glucose

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Blood Glucose (metabolism)
• Cerebral Hemorrhage (blood, epidemiology)
• China (epidemiology)
• Fasting (blood)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Male
• Middle Aged
• Prospective Studies
• Risk Factors