Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes
Background Metabolic abnormalities, such as impaired fasting glucose (IFG), are dynamic phenomena; however, it is unclear whether the timing of IFG exposure and cumulative exposure to IFG are related to cardiovascular disease (CVD) and mortality risk. Methods Data were extracted from a nationwide po...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Korean Endocrine Society
2021-10-01
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| Series: | Endocrinology and Metabolism |
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| Online Access: | http://www.e-enm.org/upload/pdf/enm-2021-1218.pdf |
| _version_ | 1818756059964112896 |
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| author | Seung-Hwan Lee Kyungdo Han Hyuk-Sang Kwon Mee Kyoung Kim |
| author_facet | Seung-Hwan Lee Kyungdo Han Hyuk-Sang Kwon Mee Kyoung Kim |
| author_sort | Seung-Hwan Lee |
| collection | DOAJ |
| description | Background Metabolic abnormalities, such as impaired fasting glucose (IFG), are dynamic phenomena; however, it is unclear whether the timing of IFG exposure and cumulative exposure to IFG are related to cardiovascular disease (CVD) and mortality risk. Methods Data were extracted from a nationwide population-based cohort in South Korea for adults (n=2,206,679) who were free of diabetes and had 4 years of consecutive health examination data. Fasting blood glucose levels of 100 to 125 mg/dL were defined as IFG, and the number of IFG diagnoses for each adult in the 4-year period was tabulated as the IFG exposure score (range, 0 to 4). Adults with persistent IFG for the 4-year period received a score of 4. Results The median follow-up was 8.2 years. There were 24,820 deaths, 13,502 cases of stroke, and 13,057 cases of myocardial infarction (MI). IFG exposure scores of 1, 2, 3, and 4 were associated with all-cause mortality (multivariable-adjusted hazard ratio [aHR], 1.11; 95% confidence interval [CI], 1.08 to 1.15; aHR, 1.16; 95% CI, 1.12 to 1.20; aHR, 1.20; 95% CI, 1.15 to 1.25; aHR, 1.18; 95% CI, 1.11 to 1.25, respectively) compared with an IFG exposure score of 0. Adjusting for hypertension and dyslipidemia attenuated the slightly increased risk of MI or stroke associated with high IFG exposure scores, but significant associations for all-cause mortality remained. Conclusion The intensity of IFG exposure was associated with an elevated risk of all-cause mortality, independent of cardiovascular risk factors. The association between IFG exposure and CVD risk was largely mediated by the coexistence of dyslipidemia and hypertension. |
| first_indexed | 2024-12-18T05:49:02Z |
| format | Article |
| id | doaj.art-fbb14ed564ff47e9b03ba1eed2de11ce |
| institution | Directory Open Access Journal |
| issn | 2093-596X 2093-5978 |
| language | English |
| last_indexed | 2024-12-18T05:49:02Z |
| publishDate | 2021-10-01 |
| publisher | Korean Endocrine Society |
| record_format | Article |
| series | Endocrinology and Metabolism |
| spelling | doaj.art-fbb14ed564ff47e9b03ba1eed2de11ce2022-12-21T21:18:58ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782021-10-013651007101510.3803/EnM.2021.12182233Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular OutcomesSeung-Hwan Lee0Kyungdo Han1Hyuk-Sang Kwon2Mee Kyoung Kim3 Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaBackground Metabolic abnormalities, such as impaired fasting glucose (IFG), are dynamic phenomena; however, it is unclear whether the timing of IFG exposure and cumulative exposure to IFG are related to cardiovascular disease (CVD) and mortality risk. Methods Data were extracted from a nationwide population-based cohort in South Korea for adults (n=2,206,679) who were free of diabetes and had 4 years of consecutive health examination data. Fasting blood glucose levels of 100 to 125 mg/dL were defined as IFG, and the number of IFG diagnoses for each adult in the 4-year period was tabulated as the IFG exposure score (range, 0 to 4). Adults with persistent IFG for the 4-year period received a score of 4. Results The median follow-up was 8.2 years. There were 24,820 deaths, 13,502 cases of stroke, and 13,057 cases of myocardial infarction (MI). IFG exposure scores of 1, 2, 3, and 4 were associated with all-cause mortality (multivariable-adjusted hazard ratio [aHR], 1.11; 95% confidence interval [CI], 1.08 to 1.15; aHR, 1.16; 95% CI, 1.12 to 1.20; aHR, 1.20; 95% CI, 1.15 to 1.25; aHR, 1.18; 95% CI, 1.11 to 1.25, respectively) compared with an IFG exposure score of 0. Adjusting for hypertension and dyslipidemia attenuated the slightly increased risk of MI or stroke associated with high IFG exposure scores, but significant associations for all-cause mortality remained. Conclusion The intensity of IFG exposure was associated with an elevated risk of all-cause mortality, independent of cardiovascular risk factors. The association between IFG exposure and CVD risk was largely mediated by the coexistence of dyslipidemia and hypertension.http://www.e-enm.org/upload/pdf/enm-2021-1218.pdfprediabetic stateblood glucoserisk factorscardiovascular diseases |
| spellingShingle | Seung-Hwan Lee Kyungdo Han Hyuk-Sang Kwon Mee Kyoung Kim Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes Endocrinology and Metabolism prediabetic state blood glucose risk factors cardiovascular diseases |
| title | Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes |
| title_full | Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes |
| title_fullStr | Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes |
| title_full_unstemmed | Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes |
| title_short | Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes |
| title_sort | frequency of exposure to impaired fasting glucose and risk of mortality and cardiovascular outcomes |
| topic | prediabetic state blood glucose risk factors cardiovascular diseases |
| url | http://www.e-enm.org/upload/pdf/enm-2021-1218.pdf |
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