Fasting plasma glucose in non-diabetic participants and the risk for incident cardiovascular events, diabetes, and mortality: results from WOSCOPS 15-year follow-up(dagger)

Preiss, D. , Welsh, P. , Murray, H., Shepherd, J., Packard, C. , Macfarlane, P., Cobbe, S., Ford, I. and Sattar, N. (2010) Fasting plasma glucose in non-diabetic participants and the risk for incident cardiovascular events, diabetes, and mortality: results from WOSCOPS 15-year follow-up(dagger). European Heart Journal, 31(10), pp. 1230-1236. (doi:10.1093/eurheartj/ehq095)

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Abstract

The evidence base for fasting plasma glucose (FPG) in the non-diabetic range as a risk factor for cardiovascular disease (CVD) is inconclusive. We investigated this question in the West of Scotland Coronary Prevention Study (WOSCOPS). In WOSCOPS, we related FPG in 6447 men (mean age 55 years) with hypercholesterolaemia, but no history of CVD or diabetes, to the risk of cardiovascular events and mortality over 14.7 years of follow-up; 2381 non-fatal/fatal cardiovascular events and 1244 deaths occurred. Participants were divided into fifths of baseline FPG, Q1 (< 4.3 mmol/L) to Q5 (> 5.1-6.9 mmol/L). Q2 was designated the referent based on previous studies which have suggested a J-shaped relationship between FPG and CVD. Compared with Q2 (> 4.3-4.6 mmol/L), men in Q5 had no elevated risk for cardiovascular events [hazard ratio (HR) 0.95 (0.83-1.08)], or all-cause mortality [HR 0.96 (0.80-1.15)] in fully adjusted analyses despite a significant risk for incident diabetes [HR 22.05 (10.75-45.22)]. After further dividing Q5 into fifths, Q5a-e, individuals in Q5e (FPG 5.8-6.9 mmol/L) were also not at increased risk of cardiovascular events [HR 1.05 (0.82-1.35)] or other endpoints compared with Q2. All results were similar using Q1 as the referent. Elevations in FPG in the non-diabetic range were not associated with long-term risk of cardiovascular events in middle-aged men in WOSCOPS. These data suggest that the current FPG cutoff for diagnosing diabetes also appropriately identifies western men at risk of CVD

Item Type:Articles
Keywords:AGE BLOOD-GLUCOSE cardiovascular disease CARDIOVASCULAR EVENTS CARDIOVASCULAR-DISEASE CARE Cohort CORONARY-HEART-DISEASE DEATH DEATHS diabetes Diabetes mellitus DISEASE ENGLAND EVENTS FOLLOW-UP GLUCOSE HEART HYPERGLYCEMIA Impaired fasting glycaemia INCREASED RISK INDIVIDUALS LONG-TERM LONG-TERM RISK MELLITUS MEN METAANALYSIS MIDDLE-AGED MEN MORTALITY PEOPLE PLASMA PREVENTION RISK RISK-FACTOR Scotland SYSTEM trials
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Macfarlane, Professor Peter and Shepherd, Prof James and Murray, Mrs Heather and Welsh, Dr Paul and Ford, Professor Ian and Preiss, Dr David and Cobbe, Professor Stuart and Packard, Professor Chris and Sattar, Professor Naveed
Authors: Preiss, D., Welsh, P., Murray, H., Shepherd, J., Packard, C., Macfarlane, P., Cobbe, S., Ford, I., and Sattar, N.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:European Heart Journal
ISSN:0195-668X

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