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High risk of cardiovascular mortality in individuals with impaired fasting glucose is explained by conversion to diabetes: the Hoorn study.
Diabetes Care. 2007 Feb; 30(2):332-6.DC

Abstract

OBJECTIVE

To optimize identification of future diabetic patients, the American Diabetes Association (ADA) introduced criteria for impaired fasting glucose (IFG) in 1997 (IFG 6.1 mmol/l [IFG6.1]) and lowered the threshold from 6.1 to 5.6 mmol/l (IFG5.6) in 2003. Our aim was to assess the consequences of lowering the IFG cutoff on the risk of cardiovascular disease (CVD) mortality and to evaluate whether this risk is explained by a conversion to type 2 diabetes within 6.4 years.

RESEARCH DESIGN AND METHODS

In a population-based cohort, the Hoorn Study, plasma glucose was determined in 1989 and 1996 (n = 1,428). Subjects were classified in 1989 according to 1997 and 2003 ADA criteria. Subjects with IFG in 1989 were further classified according to diabetes status in 1996. Hazard ratios for CVD mortality (n = 81) in the period 1996-2005 were adjusted for age and sex.

RESULTS

Subjects with IFG6.1, but not IFG5.6, had a significantly higher CVD mortality risk than normal fasting glucose (NFG) subjects. Subjects who converted from IFG to diabetes (IFG6.1: 42%; IFG5.6: 21%) had a more than twofold risk of CVD mortality (IFG6.1: 2.47 [1.17-5.19]; IFG5.6: 2.14 [1.12-4.10]) than subjects with NFG. IFG subjects who did not develop diabetes did not have significantly higher CVD mortality risks (IFG6.1: 1.50 [0.72-3.15]; IFG5.6: 1.15 [0.69-1.93]).

CONCLUSIONS

The lower cutoff for IFG (ADA 2003 criteria) results in a category of IFG that no longer represents a high-risk state of CVD. Furthermore, only subjects who convert from IFG to diabetes have a high risk of CVD mortality.

Authors+Show Affiliations

EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands. j.rijkelijkhuizen@vumc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17259503

Citation

Rijkelijkhuizen, Josina M., et al. "High Risk of Cardiovascular Mortality in Individuals With Impaired Fasting Glucose Is Explained By Conversion to Diabetes: the Hoorn Study." Diabetes Care, vol. 30, no. 2, 2007, pp. 332-6.
Rijkelijkhuizen JM, Nijpels G, Heine RJ, et al. High risk of cardiovascular mortality in individuals with impaired fasting glucose is explained by conversion to diabetes: the Hoorn study. Diabetes Care. 2007;30(2):332-6.
Rijkelijkhuizen, J. M., Nijpels, G., Heine, R. J., Bouter, L. M., Stehouwer, C. D., & Dekker, J. M. (2007). High risk of cardiovascular mortality in individuals with impaired fasting glucose is explained by conversion to diabetes: the Hoorn study. Diabetes Care, 30(2), 332-6.
Rijkelijkhuizen JM, et al. High Risk of Cardiovascular Mortality in Individuals With Impaired Fasting Glucose Is Explained By Conversion to Diabetes: the Hoorn Study. Diabetes Care. 2007;30(2):332-6. PubMed PMID: 17259503.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High risk of cardiovascular mortality in individuals with impaired fasting glucose is explained by conversion to diabetes: the Hoorn study. AU - Rijkelijkhuizen,Josina M, AU - Nijpels,Giel, AU - Heine,Robert J, AU - Bouter,Lex M, AU - Stehouwer,Coen D A, AU - Dekker,Jacqueline M, PY - 2007/1/30/pubmed PY - 2007/6/15/medline PY - 2007/1/30/entrez SP - 332 EP - 6 JF - Diabetes care JO - Diabetes Care VL - 30 IS - 2 N2 - OBJECTIVE: To optimize identification of future diabetic patients, the American Diabetes Association (ADA) introduced criteria for impaired fasting glucose (IFG) in 1997 (IFG 6.1 mmol/l [IFG6.1]) and lowered the threshold from 6.1 to 5.6 mmol/l (IFG5.6) in 2003. Our aim was to assess the consequences of lowering the IFG cutoff on the risk of cardiovascular disease (CVD) mortality and to evaluate whether this risk is explained by a conversion to type 2 diabetes within 6.4 years. RESEARCH DESIGN AND METHODS: In a population-based cohort, the Hoorn Study, plasma glucose was determined in 1989 and 1996 (n = 1,428). Subjects were classified in 1989 according to 1997 and 2003 ADA criteria. Subjects with IFG in 1989 were further classified according to diabetes status in 1996. Hazard ratios for CVD mortality (n = 81) in the period 1996-2005 were adjusted for age and sex. RESULTS: Subjects with IFG6.1, but not IFG5.6, had a significantly higher CVD mortality risk than normal fasting glucose (NFG) subjects. Subjects who converted from IFG to diabetes (IFG6.1: 42%; IFG5.6: 21%) had a more than twofold risk of CVD mortality (IFG6.1: 2.47 [1.17-5.19]; IFG5.6: 2.14 [1.12-4.10]) than subjects with NFG. IFG subjects who did not develop diabetes did not have significantly higher CVD mortality risks (IFG6.1: 1.50 [0.72-3.15]; IFG5.6: 1.15 [0.69-1.93]). CONCLUSIONS: The lower cutoff for IFG (ADA 2003 criteria) results in a category of IFG that no longer represents a high-risk state of CVD. Furthermore, only subjects who convert from IFG to diabetes have a high risk of CVD mortality. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/17259503/High_risk_of_cardiovascular_mortality_in_individuals_with_impaired_fasting_glucose_is_explained_by_conversion_to_diabetes:_the_Hoorn_study_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=17259503 DB - PRIME DP - Unbound Medicine ER -