Relations of Postload and Fasting Glucose With Incident Cardiovascular Disease and Mortality Late in Life: The Cardiovascular Health Study
| Autor: | Robert C. Kaplan, Ian DeBoer, Luc Djoussé, Evan L. Thacker, Joachim H. Ix, Joshua I. Barzilay, Kenneth J. Mukamal, Nicholas L. Smith, Mary L. Biggs, Erika F. Brutsaert, Jorge R. Kizer, Bruce M. Psaty, David S. Siscovick, Sanyog G. Shitole |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Aging 030209 endocrinology & metabolism Risk Assessment 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Diabetes mellitus Epidemiology medicine Humans 030212 general & internal medicine Prospective Studies Prospective cohort study Survival rate Glycemic Aged Proportional Hazards Models Glucose tolerance test medicine.diagnostic_test business.industry Proportional hazards model Incidence (epidemiology) Incidence Fasting Glucose Tolerance Test medicine.disease Health Surveys United States Survival Rate Endocrinology Glucose Cardiovascular Diseases Cardiology Female Geriatrics and Gerontology business Research Article Follow-Up Studies |
| Popis: | Background Older adults have a high prevalence of postload hyperglycemia. Postload glucose has shown more robust associations with cardiovascular disease (CVD) and death than fasting glucose, but data in the oldest old are sparse. Methods Fasting and 2-hour postload glucose were measured in community-dwelling older adults, mean age 78, at the 1996-1997 follow-up visit of the Cardiovascular Health Study. We evaluated their associations with atherosclerotic CVD (ASCVD) and mortality using standard Cox regression and competing-risks analyses and assessed improvement in prediction-model discrimination with the c-statistic. Results Among 2,394 participants without treated diabetes and available data on glycemic measures, there were 579 ASCVD events and 1,698 deaths during median follow-up of 11.2 years. In fully adjusted models, both fasting and 2-hour glucose were associated with ASCVD (HR per SD, 1.13 [1.03-1.25] and 1.17 [1.07-1.28], respectively) and all-cause mortality (HR 1.12 [1.07-1.18] and 1.14 [1.08-1.20]). After mutual adjustment, however, the associations for fasting glucose with both outcomes were abolished, but those for postload glucose were largely unchanged. Consistent findings were observed for ASCVD in competing-risks models. Conclusion In adults surviving to advanced old age, postload glucose was associated with ASCVD and mortality independently of fasting glucose, but fasting glucose was not associated with these outcomes independently of postload glucose. These findings affirm the robust association of postload glucose with ASCVD and death late in life. |
| Databáze: | OpenAIRE |
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