Hyperglycaemia and mortality from all causes and from cardiovascular disease in five populations of Asian origin

Abstract

Aims/hypothesis: The study was done to assess how well fasting and 2-h plasma glucose (FPG, 2-h PG) after a 75-g OGTT predict cardiovascular disease (CVD) and all-cause mortality in Asian subjects.

Methods: People ( n=6817) of Japanese and Asian Indian origin from five prospective studies in five countries were monitored for 5 to 10 years. Hazard ratios for death from all causes and CVD were estimated using Cox proportional hazard models, adjusting for FPG, 2-h PG and established risk factors.

Results: Multivariate Cox regression analysis showed that an increase in FPG from 7.0 to 8.0 mmol/l (increase of 0.76 SD) increased relative risk (95% CI) by 1.14 (1.05-1.25) for all-cause and 1.24 (1.10-1.39) for CVD mortality. An increase in 2-h PG from 9.0 to 11.9 mmol/l (0.76 SD) increased relative risks by 1.29 (1.18-1.41) and 1.35 (1.19-1.54). Inclusion of 2-h PG in the FPG model improved the predictive value ( p<0.001), whereas FPG did not influence the predictive value of 2-h PG ( p>10). In a model containing FPG and 2-h PG, hazards ratios for 2-h PG in subjects with IGT or diabetes were 1.35 (1.03-1.77) or 3.03 (2.18-4.21) for all-cause and 1.27 (0.86-1.88) or 3.39 (2.14-5.37) for CVD mortality, compared with normal subjects. The respective hazards ratio for FPG in subjects with IFG or diabetes were 0.94 (0.68-1.31) or 0.88 (0.59-1.32) for all-cause and 1.05 (0.67-1.65) or 0.88 (0.51-1.51) for CVD mortality, compared with normal subjects.

Conclusions/interpretation: For prediction of premature death, 2-h PG was superior to FPG in several Asian populations.