Postchallenge hyperglycemia and mortality in a national sample of U.S. adults.

Publisher: American Diabetes Association Country of Publication: United States NLM ID: 7805975 Publication Model: Print Cited Medium: Print ISSN: 0149-5992 (Print) Linking ISSN: 01495992 NLM ISO Abbreviation: Diabetes Care Subsets: MEDLINE

Publication: Alexandria Va : American Diabetes Association
Original Publication: New York, American Diabetes Assn.

Glucose Intolerance/*epidemiology ; Hyperglycemia/*epidemiology; Adult ; Aged ; Blood Glucose/analysis ; Blood Glucose/metabolism ; Blood Pressure ; Body Mass Index ; Cohort Studies ; Coronary Disease/epidemiology ; Diabetes Mellitus/epidemiology ; Educational Status ; Ethnicity ; Female ; Glucose Intolerance/mortality ; Glucose Tolerance Test ; Humans ; Hyperglycemia/mortality ; Male ; Middle Aged ; Prospective Studies ; Reference Values ; Smoking ; United States/epidemiology

Objective: Although postchallenge hyperglycemia is a well-established feature of type 2 diabetes, its association with risk of mortality is uncertain. Therefore, the aim of this study was to assess the independent association of fasting and 2-h glucose levels with all-cause and cardiovascular disease (CVD) mortality.
Research Design and Methods: We analyzed data from the Second National Health and Nutrition Examination Survey (NHANES II) Mortality Study, a prospective cohort study of U.S. adults examined in the NHANES II, and focused on the 3,092 adults aged 30-74 years who underwent an oral glucose tolerance test at baseline (1976-1980). Deaths were identified from U.S. national mortality files from 1976 to 1992. To account for the complex survey design, we used SUDAAN statistical software for weighted analysis.
Results: Compared with their normoglycemic counterparts (fasting glucose [FG] < 7.0 and 2-h glucose < 7.8 mmol/l), adults with fasting and postchallenge hyperglycemia (FG > or =7.0 and 2-h glucose > or =11.1 mmol/l) had a twofold higher risk of death after 16 years of follow-up (age- and sex-adjusted relative hazard [RH] 2.1, 95% CI 1.4-3.2). However, adults with isolated postchallenge hyperglycemia (FG < 7.0 and 2-h glucose > or =11.1 mmol/l) were also at higher risk of death (1.6, 1.0-2.6). In proportional hazards analysis, FG (fully adjusted RH 1.10 per 1 SD; 95% CI 1.01, 1.22) and 2-h glucose (1.14, 1.00-1.29) showed nearly identical predictive value for mortality. Similar trends were observed for CVD mortality.
Conclusions: These results suggest that postchallenge hyperglycemia is associated with increased risk of all-cause and CVD mortality independently of other CVD risk factors.

0 (Blood Glucose)

Date Created: 20010727 Date Completed: 20010927 Latest Revision: 20211203

20221213

10.2337/diacare.24.8.1397

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