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Two-hour glucose is a better risk predictor for incident coronary heart disease and cardiovascular mortality than fasting glucose.

AbstractAIMS:
To assess the predictive value of fasting and 2-h glucose after a 75 g glucose load, with regard to incidence of coronary heart disease and cardiovascular mortality.
METHODS AND RESULTS:
6766 subjects from five Finnish cohorts aged 30-89 years were followed up for 7-10 years. Hazards ratios associated with increasing glucose concentrations were homogeneous over studies. Multivariate Cox regression analyses showed that the hazards ratio for one standard deviation increase in 2-h glucose after logarithmic transformation was 1.17 (95% CI 1.05-1.30) for coronary heart disease incidence and 1.22 (1.09-1.37) for cardiovascular mortality. For fasting glucose, they were 1.05 (0.94-1.17) and 1.13 (1.01-1.25), respectively. Inclusion of 2-h glucose in the model based on fasting glucose significantly improved the prediction (P<0.005 for coronary heart disease incidence and P<0.025 for cardiovascular mortality), whereas fasting glucose did not add significant information to the model initially based on 2-h glucose (P>0.10 for both events).
CONCLUSION:
In subjects without a prior history of diabetes the association of 2-h glucose with coronary heart disease incidence and cardiovascular morality is graded and independent. The results of our study indicate that 2-h glucose is superior to fasting glucose in assessing the risk of future cardiovascular disease events.
AuthorsQ Qiao, K Pyörälä, M Pyörälä, A Nissinen, J Lindström, R Tilvis, J Tuomilehto
JournalEuropean heart journal (Eur Heart J) Vol. 23 Issue 16 Pg. 1267-75 (Aug 2002) ISSN: 0195-668X [Print] England
PMID12175663 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright 2002 The European Society of Cardiology Published by Elsevier Science Ltd.
Chemical References
  • Blood Glucose
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Glucose (metabolism)
  • Coronary Disease (epidemiology, etiology)
  • Fasting (blood)
  • Female
  • Finland (epidemiology)
  • Follow-Up Studies
  • Glucose Intolerance (complications, diagnosis)
  • Glucose Tolerance Test (methods)
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Risk Assessment
  • Survival Rate
  • Time Factors

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