One-hour plasma glucose as a long-term predictor of cardiovascular events and all-cause mortality in a Chinese older male population without diabetes: A 20-year retrospective and prospective study
IntroductionElevated one-hour plasma glucose (1 h-PG) during oral glucose tolerance test predicts the development of type 2 diabetes mellitus and its complications. However, to date, there have been no studies investigating the predictive values of 1 h-PG for the risk of cardiovascular diseases (CVD...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.947292/full |
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| author | Lingjun Rong Lingjun Rong Xiaoling Cheng Zaigang Yang Yanping Gong Chunlin Li Shuangtong Yan Banruo Sun |
| author_facet | Lingjun Rong Lingjun Rong Xiaoling Cheng Zaigang Yang Yanping Gong Chunlin Li Shuangtong Yan Banruo Sun |
| author_sort | Lingjun Rong |
| collection | DOAJ |
| description | IntroductionElevated one-hour plasma glucose (1 h-PG) during oral glucose tolerance test predicts the development of type 2 diabetes mellitus and its complications. However, to date, there have been no studies investigating the predictive values of 1 h-PG for the risk of cardiovascular diseases (CVDs) and all-cause mortality in the elderly population in China. This study aimed to evaluate and compare the effectiveness of 1 h-PG and two-hour plasma glucose (2 h-PG) to predict the risk of CVD and all-cause mortality in the Chinese elderly population.Materials and methodsThis retrospective and prospective cohort study was conducted using data obtained from the Chinese People’s Liberation Army General Hospital. All the non-diabetic elderly participants, who had plasma glucose measured at 0, 1, and 2 h during an OGTT (75 g glucose), were followed for 20 years. The primary outcomes were all-cause mortality, myocardial infarction, unstable angina, and stroke. Multivariate-adjusted Cox proportional hazard regression models were performed to examine the association between risk factors and outcomes and to estimate the risk of CVD and all-cause mortality based on 1 h-PG levels.ResultsA total of 862 non-diabetic male individuals were included. The median age was 74.0 (25th–75th percentile: 68.0–79.0) years. There were 480 CVD events and 191 deaths during 15,527 person-years of follow-up. The adjusted hazard ratio (HR) of 1 h-PG as a continuous variable was 1.097 (95% CI 1.027–1.172; P = 0.006) for CVD events and 1.196 (95% CI 1.115–1.281; P < 0.001) for higher risk of mortality. When compared with the lowest 1 h-PG tertile, the other tertiles were associated with CVD events (HR 1.464, 95% CI 1.031–2.080; P = 0.033 and HR 1.538, 95% CI 1.092–2.166; P = 0.014, for tertile 2 and tertile 3 compared with tertile 1, respectively), and the highest 1 h-PG tertile had a significantly higher risk of mortality (HR 2.384, 95% CI 1.631–3.485; P < 0.001) after full adjustment. Compared with 1 h-PG, 2 h-PG had similar abilities to predict all-cause mortality. However, 2 h-PG was less closely associated with CVD when examined in the fully adjusted model, neither as a continuous variable nor as a categorical variable. Conversely, 1 h-PG remained an independent predictor of CVD and all-cause mortality after adjusting for various traditional risk factors.ConclusionPatients with higher 1 h-PG had a significantly increased risk of CVD and all-cause mortality regardless of prediabetes status or development of diabetes at follow-up. The 1 h-PG level might be a better predictor of cardiovascular risk than the 2 h-PG level for the Chinese elderly population. |
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| spelling | doaj.art-f62d8788f58044f0b283ca1a9ef97a622022-12-22T01:26:39ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-08-01910.3389/fcvm.2022.947292947292One-hour plasma glucose as a long-term predictor of cardiovascular events and all-cause mortality in a Chinese older male population without diabetes: A 20-year retrospective and prospective studyLingjun Rong0Lingjun Rong1Xiaoling Cheng2Zaigang Yang3Yanping Gong4Chunlin Li5Shuangtong Yan6Banruo Sun7Department of Endocrinology, Second Medical Center, Chinese People’s Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Geriatric Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Endocrinology, Second Medical Center, Chinese People’s Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Geriatric Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Endocrinology, Second Medical Center, Chinese People’s Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Endocrinology, Second Medical Center, Chinese People’s Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Endocrinology, Second Medical Center, Chinese People’s Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Endocrinology, Second Medical Center, Chinese People’s Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, ChinaIntroductionElevated one-hour plasma glucose (1 h-PG) during oral glucose tolerance test predicts the development of type 2 diabetes mellitus and its complications. However, to date, there have been no studies investigating the predictive values of 1 h-PG for the risk of cardiovascular diseases (CVDs) and all-cause mortality in the elderly population in China. This study aimed to evaluate and compare the effectiveness of 1 h-PG and two-hour plasma glucose (2 h-PG) to predict the risk of CVD and all-cause mortality in the Chinese elderly population.Materials and methodsThis retrospective and prospective cohort study was conducted using data obtained from the Chinese People’s Liberation Army General Hospital. All the non-diabetic elderly participants, who had plasma glucose measured at 0, 1, and 2 h during an OGTT (75 g glucose), were followed for 20 years. The primary outcomes were all-cause mortality, myocardial infarction, unstable angina, and stroke. Multivariate-adjusted Cox proportional hazard regression models were performed to examine the association between risk factors and outcomes and to estimate the risk of CVD and all-cause mortality based on 1 h-PG levels.ResultsA total of 862 non-diabetic male individuals were included. The median age was 74.0 (25th–75th percentile: 68.0–79.0) years. There were 480 CVD events and 191 deaths during 15,527 person-years of follow-up. The adjusted hazard ratio (HR) of 1 h-PG as a continuous variable was 1.097 (95% CI 1.027–1.172; P = 0.006) for CVD events and 1.196 (95% CI 1.115–1.281; P < 0.001) for higher risk of mortality. When compared with the lowest 1 h-PG tertile, the other tertiles were associated with CVD events (HR 1.464, 95% CI 1.031–2.080; P = 0.033 and HR 1.538, 95% CI 1.092–2.166; P = 0.014, for tertile 2 and tertile 3 compared with tertile 1, respectively), and the highest 1 h-PG tertile had a significantly higher risk of mortality (HR 2.384, 95% CI 1.631–3.485; P < 0.001) after full adjustment. Compared with 1 h-PG, 2 h-PG had similar abilities to predict all-cause mortality. However, 2 h-PG was less closely associated with CVD when examined in the fully adjusted model, neither as a continuous variable nor as a categorical variable. Conversely, 1 h-PG remained an independent predictor of CVD and all-cause mortality after adjusting for various traditional risk factors.ConclusionPatients with higher 1 h-PG had a significantly increased risk of CVD and all-cause mortality regardless of prediabetes status or development of diabetes at follow-up. The 1 h-PG level might be a better predictor of cardiovascular risk than the 2 h-PG level for the Chinese elderly population.https://www.frontiersin.org/articles/10.3389/fcvm.2022.947292/fullone-hour plasma glucosecardiovascular diseasesall-cause mortalitypredictionolder adults |
| spellingShingle | Lingjun Rong Lingjun Rong Xiaoling Cheng Zaigang Yang Yanping Gong Chunlin Li Shuangtong Yan Banruo Sun One-hour plasma glucose as a long-term predictor of cardiovascular events and all-cause mortality in a Chinese older male population without diabetes: A 20-year retrospective and prospective study Frontiers in Cardiovascular Medicine one-hour plasma glucose cardiovascular diseases all-cause mortality prediction older adults |
| title | One-hour plasma glucose as a long-term predictor of cardiovascular events and all-cause mortality in a Chinese older male population without diabetes: A 20-year retrospective and prospective study |
| title_full | One-hour plasma glucose as a long-term predictor of cardiovascular events and all-cause mortality in a Chinese older male population without diabetes: A 20-year retrospective and prospective study |
| title_fullStr | One-hour plasma glucose as a long-term predictor of cardiovascular events and all-cause mortality in a Chinese older male population without diabetes: A 20-year retrospective and prospective study |
| title_full_unstemmed | One-hour plasma glucose as a long-term predictor of cardiovascular events and all-cause mortality in a Chinese older male population without diabetes: A 20-year retrospective and prospective study |
| title_short | One-hour plasma glucose as a long-term predictor of cardiovascular events and all-cause mortality in a Chinese older male population without diabetes: A 20-year retrospective and prospective study |
| title_sort | one hour plasma glucose as a long term predictor of cardiovascular events and all cause mortality in a chinese older male population without diabetes a 20 year retrospective and prospective study |
| topic | one-hour plasma glucose cardiovascular diseases all-cause mortality prediction older adults |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.947292/full |
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