Continuous relationships between non-diabetic hyperglycaemia and both cardiovascular disease and all-cause mortality: the Australian Diabetes, Obesity, and Lifestyle (AusDiab) study

被引:139
作者
Barr, E. L. M. [1 ,2 ]
Boyko, E. J. [1 ]
Zimmet, P. Z. [1 ,2 ]
Wolfe, R. [2 ]
Tonkin, A. M. [2 ]
Shaw, J. E. [1 ,2 ]
机构
[1] Baker IDI Heart & Diabet Inst, Caulfield, Vic 3162, Australia
[2] Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, Australia
基金
英国医学研究理事会;
关键词
Cardiovascular disease; Diabetes; Hyperglycaemia; Mortality; CORONARY-HEART-DISEASE; IMPAIRED FASTING GLUCOSE; BLOOD-GLUCOSE; PLASMA-GLUCOSE; RISK-FACTOR; FOLLOW-UP; CANCER; ASSOCIATION; PREDICTOR; WOMEN;
D O I
10.1007/s00125-008-1246-y
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Hyperglycaemia is a risk factor for cardiovascular disease (CVD) and all-cause mortality in individuals without diabetes. We investigated: (1) whether the risk of all-cause and CVD mortality extended continuously throughout the range of fasting plasma glucose (FPG), 2 h plasma glucose (2hPG) and HbA(1c) values; and (2) the ability of these measures to improve risk prediction for mortality. Data on 10,026 people aged a parts per thousand yen25 years without diagnosed diabetes were obtained from the population-based Australian Diabetes, Obesity and Lifestyle study. Between 1999 and 2000, FPG, 2hPG and HbA(1c) were assessed and all-cause (332 deaths) and CVD (88 deaths) mortality were obtained after 7 years. Both 2hPG and HbA(1c) exhibited linear relationships with all-cause and CVD mortality, whereas FPG showed J-shaped relationships. The adjusted HR (95% CI) for all-cause mortality per SD increase was 1.2 (1.1-1.3) for 2hPG and 1.1 (1.0-1.2) for HbA(1c). The HR for FPG < 5.1 mmol/l (per SD decrease) was 2.0 (1.3-3.0); for FPG a parts per thousand yen5.1 mmol/l (per SD increase) the HR was 1.1 (1.0-1.2). Corresponding HRs for CVD mortality were 1.2 (1.0-1.4), 1.2 (1.0-1.3), 4.0 (2.1-7.6) and 1.3 (1.1-1.4). The discriminative ability of each measure was similar; no measure substantially improved individual risk identification over traditional risk factors. In individuals without diagnosed diabetes, 2hPG and FPG, but not HbA(1c) were significant predictors of all-cause mortality, whereas all measures were significant predictors of CVD mortality. However, these glucose measures did not substantially improve individual risk identification.
引用
收藏
页码:415 / 424
页数:10
相关论文
共 48 条
  • [1] NEW LOOK AT STATISTICAL-MODEL IDENTIFICATION
    AKAIKE, H
    [J]. IEEE TRANSACTIONS ON AUTOMATIC CONTROL, 1974, AC19 (06) : 716 - 723
  • [2] [Anonymous], 1999, Definition, diagnosis, and classification of diabetes mellitus and its complications: report of a WHO consultation
  • [3] [Anonymous], 2006, DEF DIAGN DIAB MELL
  • [4] Is there glycemic threshold for mortality risk?
    Balkau, B
    Bertrais, S
    Ducimetiere, P
    Eschwege, E
    [J]. DIABETES CARE, 1999, 22 (05) : 696 - 699
  • [5] High blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men -: 20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen Study
    Balkau, B
    Shipley, M
    Jarrett, RJ
    Pyörälä, K
    Pyörälä, M
    Forhan, A
    Eschwège, E
    [J]. DIABETES CARE, 1998, 21 (03) : 360 - 367
  • [6] Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance - The Australian diabetes, obesity, and lifestyle study (AusDiab)
    Barr, Elizabeth L. M.
    Zimmet, Paul Z.
    Welborn, Timothy A.
    Jolley, Damien
    Magliano, Dianna J.
    Dunstan, David W.
    Cameron, Adrian J.
    Dwyer, Terry
    Taylor, Hugh R.
    Tonkin, Andrew M.
    Wong, Tien Y.
    McNeil, John
    Shaw, Jonathan E.
    [J]. CIRCULATION, 2007, 116 (02) : 151 - 157
  • [7] Glucose tolerance and cardiovascular mortality -: Comparison of fasting and 2-hour diagnostic criteria
    Borch-Johnsen, K
    Neil, A
    Balkau, B
    Larsen, S
    Nissinen, A
    Pekkanen, J
    Tuomilehto, J
    Jousilahti, P
    Lindstrom, J
    Pyörälä, M
    Pyörälä, K
    Eschwege, E
    Gallus, G
    Garancini, MP
    Bouter, LM
    Dekker, JM
    Heine, RJ
    Nijpels, HG
    Stehouwer, CDA
    Feskens, EJM
    Kromhout, D
    Peltonen, M
    Pajak, A
    Eriksson, J
    Qiao, Q
    [J]. ARCHIVES OF INTERNAL MEDICINE, 2001, 161 (03) : 397 - 405
  • [8] A New Zealand linkage study examining the associations between A1C concentration and mortality
    Brewer, Naomi
    Wright, Craig S.
    Travier, Noeme
    Cunningham, Chris W.
    Hornell, John
    Pearce, Neil
    Jeffreys, Mona
    [J]. DIABETES CARE, 2008, 31 (06) : 1144 - 1149
  • [9] Untreated hypertension among Australian adults: the 1999-2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab)
    Briganti, EM
    Shaw, JE
    Chadban, SJ
    Zimmet, PZ
    Welborn, TA
    McNeil, JJ
    Atkins, RC
    [J]. MEDICAL JOURNAL OF AUSTRALIA, 2003, 179 (03) : 135 - 139
  • [10] Brunner EJ, 2006, DIABETES CARE, V29, P26