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

M. Hyvarinen, Q. Qiao, J. Tuomilehto, T. Laatikainen, R.J. Heine, C.D.A. Stehouwer, K.G.M.M. Alberti, K. Pyorala, B. Zethelius, B. Stegmayr

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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
Original languageUndefined/Unknown
Pages (from-to)348-354
JournalDiabetes Care
Issue number2
Publication statusPublished - 2009

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Hyvarinen, M., Qiao, Q., Tuomilehto, J., Laatikainen, T., Heine, R. J., Stehouwer, C. D. A., ... Stegmayr, B. (2009). Hyperglycemia and stroke mortality: comparison between fasting and 2-h glucose criteria. Diabetes Care, 32(2), 348-354. https://doi.org/10.2337/dc08-1411