Non-fasting blood glucose and risk of incident coronary heart disease in middle-aged general population: the Circulatory Risk in Communities Study (CIRCS).

ABSTRACT

OBJECTIVE: The objective was to determine whether non-fasting glucose concentration is a predictor for incident coronary heart disease. METHODS: We investigated a cohort data of 9,900 40- to 69-year-old residents in four Japanese communities for 1975-1986 baseline surveys of the Circulatory Risk in Communities Study (CIRCS). Non-fasting blood glucose concentrations were available for 7,332 participants. Diabetic type was defined as a glucose level of ≥ 11.1 mmol/L and/or the use of medication for diabetes mellitus. RESULTS: A total of 170 coronary heart disease including 113 myocardial infarctions occurred in non-fasting participants within the median 22-year follow-up period. Multivariable hazard ratios (HRs) of incident coronary heart disease for the participants with diabetic type compared with the normal type were 1.98 (0.84-4.68) for men, 3.39 (1.47-7.81) for women, and 2.47 (1.37-4.46) for total subjects. Corresponding HRs for myocardial infarction were 2.14 (0.83-5.55), 5.70 (2.21-14.67) and 3.17 (1.65-6.10), respectively. Multivariable HRs of incident coronary heart disease per one standard deviation of serum glucose levels were 1.17 (1.02-1.36), 1.19 (1.03-1.38), and 1.19 (1.08-1.32), respectively. The corresponding HRs for myocardial infarction were 1.18 (1.00-1.38), 1.27 (1.07-1.49) and 1.23 (1.10-1.37). CONCLUSION: Non-fasting glucose concentration, either as diagnosis of diabetic type or as continuous variable, proved to be an independent predictor for incident coronary heart disease in middle-aged general population.