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Comparative Study
. 2009 Feb;32(2):348-54.
doi: 10.2337/dc08-1411. Epub 2008 Nov 18.

Hyperglycemia and stroke mortality: comparison between fasting and 2-h glucose criteria

Marjukka Hyvärinen  1 , Qing Qiao, Jaakko Tuomilehto, Tiina Laatikainen, Robert J Heine, Coen D A Stehouwer, K George M M Alberti, Kalevi Pyörälä, Björn Zethelius, Birgitta Stegmayr; DECODE Study Group
Affiliations
Comparative Study

Hyperglycemia and stroke mortality: comparison between fasting and 2-h glucose criteria

Marjukka Hyvärinen et al. Diabetes Care. 2009 Feb.

Abstract

Objective: We investigated stroke mortality in individuals in different categories of glycemia and compared hazard ratios (HRs) corresponding to a 1-SD increase in 2-h plasma glucose and fasting plasma glucose (FPG) criteria.

Research design and methods: We examined data from 2-h 75-g oral glucose tolerance tests taken from 13 European cohorts comprising 11,844 (55%) men and 9,862 (45%) women who were followed up for a median of 10.5 years. A multivariate adjusted Cox proportional hazards model was used to estimate HRs for stroke mortality.

Results: In men and women without a prior history of diabetes, multivariate adjusted HRs for stroke mortality corresponding to a 1-SD increase in FPG were 1.02 (95% CI 0.83-1.25) and 1.52 (1.22-1.88) and those in 2-h plasma glucose 1.21 (1.06-1.38) and 1.31 (1.06-1.61), respectively. Addition of 2-h plasma glucose to the model with FPG significantly improved prediction of stroke mortality in men (chi2 = 10.12; P = 0.001) but not in women (chi2 = 0.01; P = 0.94), whereas addition of FPG to 2-h plasma glucose improved stroke mortality in women (chi2 = 4.08; P = 0.04) but not in men (chi2 = 3.29; P = 0.07).

Conclusions: Diabetes defined by either FPG or 2-h plasma glucose increases the risk of stroke mortality. In individuals without a history of diabetes, elevated 2-h postchallenge glucose is a better predictor than elevated fasting glucose in men, whereas the latter is better than the former in women.

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Figures

Figure 1
Figure 1
Cumulative stroke mortality curves derived from Cox regression analysis for FPG (mmol/l) and for people with prior history of diabetes (known DM) in men (A) and in women (B). The analysis is adjusted for age, study, BMI, total cholesterol, smoking, and hypertension status.
Figure 2
Figure 2
Cumulative stroke mortality curves derived from Cox regression analysis for 2-h plasma glucose (mmol/l) and for people with prior history of diabetes (known DM) in men (A) and in women (B). The analysis is adjusted for age, study, BMI, total cholesterol, smoking, and hypertension status.
See this image and copyright information in PMC

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