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Impact of impaired fasting glucose on cardiovascular disease: the Framingham Heart Study.
J Am Coll Cardiol 2008; 51(3):264-70JACC

Abstract

OBJECTIVES

We sought to determine whether impaired fasting glucose (IFG) predicts cardiovascular disease (CVD) events.

BACKGROUND

It is unclear which glucose threshold should define prediabetes. We compared the 1997 and 2003 American Diabetes Association (ADA) definitions of IFG to predict CVD.

METHODS

Framingham offspring participants free of CVD, categorized by the 1997 ADA IFG definition (fasting plasma glucose 110 to 125 mg/dl; 6.1 to 6.9 mmol/l) or the 2003 definition (100 to 125 mg/dl; 5.6 to 6.9 mmol/l), were followed from 1983 to 2004. Pooled logistic regression was used to calculate multivariable-adjusted odds ratios (ORs) for incident coronary heart disease (CHD; 291 events) or CVD (423 events).

RESULTS

Four-year CHD event rates among women were 1.3% (100 to 109 mg/dl), 2.3% (110 to 125 mg/dl), and 2.9% (diabetes); whereas corresponding rates in men were 2.9%, 3.0%, and 8.7%. For the 2003 IFG definition, the OR for CHD among women was 1.7 (95% confidence interval [CI] 1.0 to 3.0, p = 0.048), whereas for the 1997 IFG definition, the OR for CHD in women was 2.2 (95% CI 1.1 to 4.4, p = 0.02), which was almost as high as for women with diabetes (OR 2.5, 95% CI 1.2 to 5.2, p = 0.01). For CVD, only the 1997 IFG definition yielded significantly greater odds of CVD in women (OR 2.1, 95% CI 1.2 to 3.6, p = 0.01). Men were not at increased odds of developing CVD or CHD by either definition.

CONCLUSIONS

In women, both IFG definitions were associated with increased CHD risk, whereas neither IFG definition identified men at increased short-term risk for CHD or CVD. The finding that women with FPG 110 to 125 mg/dl had similar CHD risk compared with women with diabetes suggests that CHD risk in women may be elevated at a lower glucose level than for men.

Authors+Show Affiliations

National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts 01702-5827, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18206734

Citation

Levitzky, Yamini S., et al. "Impact of Impaired Fasting Glucose On Cardiovascular Disease: the Framingham Heart Study." Journal of the American College of Cardiology, vol. 51, no. 3, 2008, pp. 264-70.
Levitzky YS, Pencina MJ, D'Agostino RB, et al. Impact of impaired fasting glucose on cardiovascular disease: the Framingham Heart Study. J Am Coll Cardiol. 2008;51(3):264-70.
Levitzky, Y. S., Pencina, M. J., D'Agostino, R. B., Meigs, J. B., Murabito, J. M., Vasan, R. S., & Fox, C. S. (2008). Impact of impaired fasting glucose on cardiovascular disease: the Framingham Heart Study. Journal of the American College of Cardiology, 51(3), pp. 264-70. doi:10.1016/j.jacc.2007.09.038.
Levitzky YS, et al. Impact of Impaired Fasting Glucose On Cardiovascular Disease: the Framingham Heart Study. J Am Coll Cardiol. 2008 Jan 22;51(3):264-70. PubMed PMID: 18206734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of impaired fasting glucose on cardiovascular disease: the Framingham Heart Study. AU - Levitzky,Yamini S, AU - Pencina,Michael J, AU - D'Agostino,Ralph B, AU - Meigs,James B, AU - Murabito,Joanne M, AU - Vasan,Ramachandran S, AU - Fox,Caroline S, PY - 2007/05/24/received PY - 2007/09/12/revised PY - 2007/09/17/accepted PY - 2008/1/22/pubmed PY - 2008/1/29/medline PY - 2008/1/22/entrez SP - 264 EP - 70 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 51 IS - 3 N2 - OBJECTIVES: We sought to determine whether impaired fasting glucose (IFG) predicts cardiovascular disease (CVD) events. BACKGROUND: It is unclear which glucose threshold should define prediabetes. We compared the 1997 and 2003 American Diabetes Association (ADA) definitions of IFG to predict CVD. METHODS: Framingham offspring participants free of CVD, categorized by the 1997 ADA IFG definition (fasting plasma glucose 110 to 125 mg/dl; 6.1 to 6.9 mmol/l) or the 2003 definition (100 to 125 mg/dl; 5.6 to 6.9 mmol/l), were followed from 1983 to 2004. Pooled logistic regression was used to calculate multivariable-adjusted odds ratios (ORs) for incident coronary heart disease (CHD; 291 events) or CVD (423 events). RESULTS: Four-year CHD event rates among women were 1.3% (100 to 109 mg/dl), 2.3% (110 to 125 mg/dl), and 2.9% (diabetes); whereas corresponding rates in men were 2.9%, 3.0%, and 8.7%. For the 2003 IFG definition, the OR for CHD among women was 1.7 (95% confidence interval [CI] 1.0 to 3.0, p = 0.048), whereas for the 1997 IFG definition, the OR for CHD in women was 2.2 (95% CI 1.1 to 4.4, p = 0.02), which was almost as high as for women with diabetes (OR 2.5, 95% CI 1.2 to 5.2, p = 0.01). For CVD, only the 1997 IFG definition yielded significantly greater odds of CVD in women (OR 2.1, 95% CI 1.2 to 3.6, p = 0.01). Men were not at increased odds of developing CVD or CHD by either definition. CONCLUSIONS: In women, both IFG definitions were associated with increased CHD risk, whereas neither IFG definition identified men at increased short-term risk for CHD or CVD. The finding that women with FPG 110 to 125 mg/dl had similar CHD risk compared with women with diabetes suggests that CHD risk in women may be elevated at a lower glucose level than for men. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/18206734/Impact_of_impaired_fasting_glucose_on_cardiovascular_disease:_the_Framingham_Heart_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(07)03421-3 DB - PRIME DP - Unbound Medicine ER -