Nonfasting serum glucose and the risk of fatal stroke in diabetic and nondiabetic subjects. 18-year follow-up of the Oslo Study

Abstract

Background and purpose: The association between nonfasting serum glucose and stroke mortality for diabetic and nondiabetic subjects is presented for participants of the Oslo Study.

Methods: The study started in 1972; of 16,209 men aged 40 to 49 years, 16,172 had no previous history of stroke and 151 were known to be diabetic. Five diabetic and 80 nondiabetic subjects died of stroke during the 18 years of follow-up, giving a rate ratio of 7.87 (95% confidence interval [CI], 2.48 to 19.14). The rate of mortality for all causes in diabetic subjects was more than five times that of those who were nondiabetic.

Results: Nonfasting serum glucose was a predictor of fatal stroke in all participants (diabetic subjects included) without a history of stroke in age-adjusted univariate analysis. The relative risk was 1.13 (CI, 1.03 to 1.25) by increase of 1 mmol/L of serum glucose according to results of proportional hazards regression analysis. Accordingly, relative risk for nondiabetic subjects was 1.02 (CI, 0.83 to 1.26) with no linear trend. The rate ratio of the fifth quintile to the rest was 1.57 (CI, 0.94 to 2.56) for all participants and 1.28 (CI, 0.72 to 2.18) for nondiabetics.

Conclusions: There was an interaction between glucose level and body mass index versus stroke for all participants but not for nondiabetic subjects, with an increased risk for men with above-median values of glucose and body mass index. Analysis of nondiabetic subjects failed to show glucose as a definite predictor of fatal stroke.