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Continuous relationships between non-diabetic hyperglycaemia and both cardiovascular disease and all-cause mortality: the Australian Diabetes, Obesity, and Lifestyle (AusDiab) study.
Diabetologia. 2009 Mar; 52(3):415-24.D

Abstract

AIMS/HYPOTHESIS

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.

METHODS

Data on 10,026 people aged >or=25 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.

RESULTS

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 >or=5.1 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.

CONCLUSIONS/INTERPRETATION

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.

Authors+Show Affiliations

Baker IDI Heart and Diabetes Institute, 250 Kooyong Road, Caulfield, 3162, VIC, Australia. Elizabeth.Barr@bakeridi.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19130039

Citation

Barr, E L M., et al. "Continuous Relationships Between Non-diabetic Hyperglycaemia and Both Cardiovascular Disease and All-cause Mortality: the Australian Diabetes, Obesity, and Lifestyle (AusDiab) Study." Diabetologia, vol. 52, no. 3, 2009, pp. 415-24.
Barr EL, Boyko EJ, Zimmet PZ, et al. Continuous relationships between non-diabetic hyperglycaemia and both cardiovascular disease and all-cause mortality: the Australian Diabetes, Obesity, and Lifestyle (AusDiab) study. Diabetologia. 2009;52(3):415-24.
Barr, E. L., Boyko, E. J., Zimmet, P. Z., Wolfe, R., Tonkin, A. M., & Shaw, J. E. (2009). Continuous relationships between non-diabetic hyperglycaemia and both cardiovascular disease and all-cause mortality: the Australian Diabetes, Obesity, and Lifestyle (AusDiab) study. Diabetologia, 52(3), 415-24. https://doi.org/10.1007/s00125-008-1246-y
Barr EL, et al. Continuous Relationships Between Non-diabetic Hyperglycaemia and Both Cardiovascular Disease and All-cause Mortality: the Australian Diabetes, Obesity, and Lifestyle (AusDiab) Study. Diabetologia. 2009;52(3):415-24. PubMed PMID: 19130039.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Continuous relationships between non-diabetic hyperglycaemia and both cardiovascular disease and all-cause mortality: the Australian Diabetes, Obesity, and Lifestyle (AusDiab) study. AU - Barr,E L M, AU - Boyko,E J, AU - Zimmet,P Z, AU - Wolfe,R, AU - Tonkin,A M, AU - Shaw,J E, Y1 - 2009/01/08/ PY - 2008/07/11/received PY - 2008/12/02/accepted PY - 2009/1/9/entrez PY - 2009/1/9/pubmed PY - 2009/5/19/medline SP - 415 EP - 24 JF - Diabetologia JO - Diabetologia VL - 52 IS - 3 N2 - AIMS/HYPOTHESIS: 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. METHODS: Data on 10,026 people aged >or=25 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. RESULTS: 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 >or=5.1 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. CONCLUSIONS/INTERPRETATION: 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. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/19130039/Continuous_relationships_between_non_diabetic_hyperglycaemia_and_both_cardiovascular_disease_and_all_cause_mortality:_the_Australian_Diabetes_Obesity_and_Lifestyle__AusDiab__study_ L2 - https://doi.org/10.1007/s00125-008-1246-y DB - PRIME DP - Unbound Medicine ER -