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Hyperglycaemia is associated with all-cause and cardiovascular mortality in the Hoorn population: the Hoorn Study.
de Vegt, F; Dekker, J M; Ruhé, H G; Stehouwer, C D; Nijpels, G; Bouter, L M; Heine, R J.
Afiliação
  • de Vegt F; Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Diabetologia ; 42(8): 926-31, 1999 Aug.
Article em En | MEDLINE | ID: mdl-10491751
ABSTRACT
AIMS/

HYPOTHESIS:

The degree of glycaemia has been shown to be associated with all-cause and cardiovascular mortality in diabetic subjects. Whether this association also exists in the general population is still controversial. We studied the predictive value of fasting plasma glucose, 2-hour post-load glucose and HbA1c in a population-based cohort of 2363 older (50-75 years) subjects, without known diabetes.

METHODS:

Relative risks (RR) of all-cause and cardiovascular mortality were estimated by Cox proportional hazards model, adjusting for age and sex, and additionally for known cardiovascular risk factors.

RESULTS:

During 8 years of follow-up, 185 subjects died; 98 of cardiovascular causes. Fasting plasma glucose was only predictive in the diabetic range, although the risks started to increase at about 6.1 mmol/l. Post-load glucose and HbA1c values were, even within the non-diabetic range, associated with an increased risk (p for linear trend < 0.05). These increased risks were mostly, but not completely, attributable to known cardiovascular risk factors. After exclusion of subjects with newly diagnosed diabetes or with pre-existent cardiovascular disease (n = 551), a 5.8 mmol/l increase of post-load glucose (corresponding to two standard deviations of the population distribution) was associated with a higher age-adjusted and sex-adjusted risk of all-cause (RR 2.24) and cardiovascular mortality (RR 3.40) (p < 0.05). After additional adjustment for known cardiovascular risk factors, these relative risks were still statistically significant, with values of 2.20 and 3.00 respectively (p < 0.05). CONCLUSION/

INTERPRETATION:

High glycaemic variables, especially 2-h post-load glucose concentrations and to a lesser extent HbA1c values, indicate a risk of all-cause and cardiovascular mortality in a general population without known diabetes.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Cardiovasculares / Hiperglicemia Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Diabetologia Ano de publicação: 1999 Tipo de documento: Article País de afiliação: Holanda
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Cardiovasculares / Hiperglicemia Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Diabetologia Ano de publicação: 1999 Tipo de documento: Article País de afiliação: Holanda