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Relations of Postload and Fasting Glucose With Incident Cardiovascular Disease and Mortality Late in Life: The Cardiovascular Health Study.
Tuesday,2015-10-06 13:41 America/Los_Angeles — zdrager
| Title | Relations of Postload and Fasting Glucose With Incident Cardiovascular Disease and Mortality Late in Life: The Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2016 |
| Authors | Brutsaert, EF, Shitole, S, Biggs, MLou, Mukamal, KJ, deBoer, IH, Thacker, EL, Barzilay, JI, Djoussé, L, Ix, JH, Smith, NL, Kaplan, RC, Siscovick, DS, Psaty, BM, Kizer, JR |
| Journal | J Gerontol A Biol Sci Med Sci |
| Volume | 71 |
| Issue | 3 |
| Pagination | 370-7 |
| Date Published | 2016 Mar |
| ISSN | 1758-535X |
| Keywords | Aged, Aging, Blood Glucose, Cardiovascular Diseases, Fasting, Female, Follow-Up Studies, Glucose, Glucose Tolerance Test, Health Surveys, Humans, Incidence, Male, Proportional Hazards Models, Prospective Studies, Risk Assessment, Risk Factors, Survival Rate, United States |
| Abstract | <p><b>BACKGROUND: </b>Older adults have a high prevalence of postload hyperglycemia. Postload glucose has shown more robust associations with cardiovascular disease (CVD) and death than fasting glucose, but data in the oldest old are sparse.</p><p><b>METHODS: </b>Fasting and 2-hour postload glucose were measured in community-dwelling older adults, mean age 78, at the 1996-1997 follow-up visit of the Cardiovascular Health Study. We evaluated their associations with atherosclerotic CVD (ASCVD) and mortality using standard Cox regression and competing-risks analyses and assessed improvement in prediction-model discrimination with the c-statistic.</p><p><b>RESULTS: </b>Among 2,394 participants without treated diabetes and available data on glycemic measures, there were 579 ASCVD events and 1,698 deaths during median follow-up of 11.2 years. In fully adjusted models, both fasting and 2-hour glucose were associated with ASCVD (HR per SD, 1.13 [1.03-1.25] and 1.17 [1.07-1.28], respectively) and all-cause mortality (HR 1.12 [1.07-1.18] and 1.14 [1.08-1.20]). After mutual adjustment, however, the associations for fasting glucose with both outcomes were abolished, but those for postload glucose were largely unchanged. Consistent findings were observed for ASCVD in competing-risks models.</p><p><b>CONCLUSION: </b>In adults surviving to advanced old age, postload glucose was associated with ASCVD and mortality independently of fasting glucose, but fasting glucose was not associated with these outcomes independently of postload glucose. These findings affirm the robust association of postload glucose with ASCVD and death late in life.</p> |
| DOI | 10.1093/gerona/glv106 |
| Alternate Journal | J. Gerontol. A Biol. Sci. Med. Sci. |
| PubMed ID | 26314953 |
| Grant List | HHSN268200800007C / / PHS HHS / United States HHSN268201200036C / / PHS HHS / United States N01HC55222 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States R01 HL-094555 / HL / NHLBI NIH HHS / United States R01AG023629 / AG / NIA NIH HHS / United States U01HL080295 / HL / NHLBI NIH HHS / United States |