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Karl-Fredrik Eriksson

Associate professor

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One-hour glucose value as a long-term predictor of cardiovascular morbidity and mortality : the Malmö Preventive Project

Author

  • Mette L. Nielsen
  • Manan Pareek
  • Margrét Leósdóttir
  • Karl Fredrik Eriksson
  • Peter M. Nilsson
  • Michael H. Olsen

Summary, in English

OBJECTIVE: To examine the predictive capability of a 1-h vs 2-h postload glucose value for cardiovascular morbidity and mortality.

DESIGN: Prospective, population-based cohort study (Malmö Preventive Project) with subject inclusion 1974-1992.

RESULTS: Median age was 48 (25th-75th percentile: 48-49) years and mean FBG 4.6 ± 0.6 mmol/L. FBG and 2-h postload BG did not independently predict cardiovascular events or death. Conversely, 1-h postload BG predicted cardiovascular morbidity and mortality and remained an independent predictor of cardiovascular death (HR: 1.09, 95% CI: 1.01-1.17, P = 0.02) and all-cause mortality (HR: 1.10, 95% CI: 1.05-1.16, P < 0.0001) after adjusting for various traditional risk factors. Clinical risk factors with added 1-h postload BG performed better than clinical risk factors alone, in predicting cardiovascular death (likelihood-ratio test, P = 0.02) and all-cause mortality (likelihood-ratio test, P = 0.0001; significant IDI, P = 0.0003).

METHODS: 4934 men without known diabetes and cardiovascular disease, who had blood glucose (BG) measured at 0, 20, 40, 60, 90 and 120 min during an OGTT (30 g glucose per m2 body surface area), were followed for 27 years. Data on cardiovascular events and death were obtained through national and local registries. Predictive capabilities of fasting BG (FBG) and glucose values obtained during OGTT alone and added to a clinical prediction model comprising traditional cardiovascular risk factors were assessed using Harrell's concordance index (C-index) and integrated discrimination improvement (IDI).

CONCLUSION: Among men without known diabetes, addition of 1-h BG, but not FBG or 2-h BG, to clinical risk factors provided incremental prognostic yield for prediction of cardiovascular death and all-cause mortality.

Department/s

  • Internal Medicine - Epidemiology
  • Vascular Diseases - Clinical Research
  • Genomics, Diabetes and Endocrinology
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence of Diabetes Research in Sweden

Publishing year

2018-03-01

Language

English

Pages

225-236

Publication/Series

European Journal of Endocrinology

Volume

178

Issue

3

Document type

Journal article

Publisher

Society of the European Journal of Endocrinology

Topic

  • Cardiac and Cardiovascular Systems
  • Endocrinology and Diabetes

Status

Published

Research group

  • Internal Medicine - Epidemiology
  • Vascular Diseases - Clinical Research
  • Genomics, Diabetes and Endocrinology

ISBN/ISSN/Other

  • ISSN: 1479-683X