Article

Fasting glucose levels within the high normal range predict cardiovascular outcome

Department of Medicine C, Sheba Medical Center, Tel Hashomer, Israel.
American heart journal (Impact Factor: 4.56). 07/2012; 164(1):111-6. DOI: 10.1016/j.ahj.2012.03.023
Source: PubMed

ABSTRACT Diabetes mellitus and impaired glucose metabolism are associated with increased risk for cardiovascular disease (CVD). However, it is still not clear whether glucose levels can predict CVD risk among patients without diabetes. The primary aim of this study is to assess whether normoglycemic fasting plasma glucose (FPG) is associated with increased risk of CVD outcomes in healthy patients.
We obtained blood measurements, data from physical examination, and medical and lifestyle information from 10,913 men and women who were evaluated in the Institute for Preventive Medicine of Sheba Medical Center. Enrolled were participants with FPG <100 mg/dL as well as 100 to 125 mg/dL, who were free of diagnosis of CVD. The participants were actively screened for coronary disease using a stress test. Primary end points were coronary heart disease or self-reported cerebral vascular disease.
A total of 1,119 incident cases of CVD occurred during a mean follow-up of 4.3 years. Subjects with fasting glucose levels in the high normal range (95-99 mg/dL) had an increased CVD risk when compared with levels <80 mg/dL, (HR 1.53;CI 95% [1.22-1.91], P < .001). A multivariate model, adjusted for age, sex, family history of CVD, blood pressure, body mass index, smoking status, pharmacologic treatment, serum triglycerides, and high-density lipoprotein and low-density lipoprotein cholesterol levels, revealed an independent increased risk of CVD with rising FPG levels in the normal range.
Elevated CVD risk is strongly and independently associated with glucose levels within the normoglycemic range. Fasting plasma glucose may help in identifying apparently healthy persons with early metabolic abnormalities who are at increased risk for CVD before progression to prediabetes and overt diabetes mellitus.

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    • "However, there are reports from the past 3 years that affirm the evidence of the risk of future CVD in prediabetes and the implications of management. For instance, one of the reports indicated that fasting plasma glucose level may help in identifying apparently healthy persons with early metabolic abnormalities who are at increased risk for CVD.[5] Others reported that upto 12% of prediabetes individuals develop DM per year.[67] "
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    11/2013; 5(11):625-630. DOI:10.4103/1947-2714.122303
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    • "Even within the normoglycemic range, elevated cardiovascular risk is strongly and independently associated with glucose levels. Subjects with fasting glucose levels in the high-normal range (95–99 mg/dL) have an increased cardiovascular risk when compared with subjects in low-normal range (< 80 mg/dL) [26]. In the present study, MPV in the high-normal glucose group (Q3) was higher than that in the low-normal glucose group (Q1). "
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