Advanced

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

Nielsen, Mette L.; Pareek, Manan; Leósdóttir, Margrét LU ; Eriksson, Karl Fredrik LU ; Nilsson, Peter M. LU and Olsen, Michael H. (2018) In European journal of endocrinology 178(3). p.225-236
Abstract

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... (More)

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.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European journal of endocrinology
volume
178
issue
3
pages
12 pages
publisher
Society of the European Journal of Endocrinology
external identifiers
  • scopus:85042463192
ISSN
1479-683X
DOI
10.1530/EJE-17-0824
language
English
LU publication?
yes
id
4f36fd60-7c8c-4692-925c-776b136cecd3
date added to LUP
2018-03-17 19:16:27
date last changed
2018-11-21 21:38:44
@article{4f36fd60-7c8c-4692-925c-776b136cecd3,
  abstract     = {<p>OBJECTIVE: To examine the predictive capability of a 1-h vs 2-h postload glucose value for cardiovascular morbidity and mortality.</p><p>DESIGN: Prospective, population-based cohort study (Malmö Preventive Project) with subject inclusion 1974-1992.</p><p>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 &lt; 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).</p><p>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).</p><p>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.</p>},
  author       = {Nielsen, Mette L. and Pareek, Manan and Leósdóttir, Margrét and Eriksson, Karl Fredrik and Nilsson, Peter M. and Olsen, Michael H.},
  issn         = {1479-683X},
  language     = {eng},
  month        = {03},
  number       = {3},
  pages        = {225--236},
  publisher    = {Society of the European Journal of Endocrinology},
  series       = {European journal of endocrinology},
  title        = {One-hour glucose value as a long-term predictor of cardiovascular morbidity and mortality : the Malmö Preventive Project},
  url          = {http://dx.doi.org/10.1530/EJE-17-0824},
  volume       = {178},
  year         = {2018},
}