Blood glucose and cerebrovascular disease in nondiabetic patients.

Publisher: Sage Publications Country of Publication: United States NLM ID: 0203706 Publication Model: Print Cited Medium: Print ISSN: 0003-3197 (Print) Linking ISSN: 00033197 NLM ISO Abbreviation: Angiology Subsets: MEDLINE

Publication: Thousand Oaks, CA : Sage Publications
Original Publication: New York [etc.] Angiology Research Foundation.

Circadian Rhythm*; Blood Glucose/*metabolism ; Glucose Intolerance/*complications ; Ischemic Attack, Transient/*blood ; Stroke/*blood; Adult ; Aged ; Female ; Follow-Up Studies ; Glucose Intolerance/blood ; Humans ; Incidence ; Ischemic Attack, Transient/epidemiology ; Ischemic Attack, Transient/etiology ; Kaplan-Meier Estimate ; Male ; Medical Records Systems, Computerized ; Middle Aged ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Stroke/epidemiology ; Stroke/etiology ; Time Factors ; United States/epidemiology

The objective of this study was to determine if elevations in blood glucose, in a range classified as impaired fasting glucose, are associated with a greater incidence of cerebrovascular disease in nondiabetic patients. Morning blood glucose determinations were evaluated with respect to subsequent stroke using records from 28 477 nondiabetic patients. Strokes and transient ischemic attacks (TIA) were identified from ICD-9 coding for a new event more than a year after baseline glucose determinations. Of the patients studied, 593 suffered stroke or TIA over a total risk analysis time of 100 982 years. Higher baseline morning glucose (100 to 126 mg/dL vs under 100 mg/dL) was associated with 31% more diagnoses (2.4% vs 1.8%, P < .001). Incidence rate was 5.3 per 1000 patient-years for those patients with glucose over 100 mg/dL and 3.9 per 1000 patient-years for those with glucose under 100 mg/dL (P <.001). Kaplan-Meier analysis showed that elevated baseline glucose was associated with a progressive, increased risk with time. A Cox proportional hazards model with adjustment for age, body mass index, sex, creatinine, lipids, smoking, and medications showed that elevated fasting glucose was associated with an increased hazard for a new event (hazard ratio 1.24, 95% CI 1.05-1.46, glucose over 100 mg/dL vs under 100 mg/dL). Thus, patients with higher baseline blood glucose levels in the absence of diabetes and after adjustment for covariants have a significantly greater risk for development of cerebrovascular disease.

0 (Blood Glucose)

Date Created: 20071121 Date Completed: 20071206 Latest Revision: 20101118

20231215

10.1177/0003319707303695

18024949