Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
Relation Between Blood Glucose and Coronary Mortality Over 33 Years in the Whitehall Study
Ist Teil von
Diabetes care, 2006-01, Vol.29 (1), p.26-31
Ort / Verlag
Alexandria, VA: American Diabetes Association
Erscheinungsjahr
2006
Quelle
MEDLINE
Beschreibungen/Notizen
Relation Between Blood Glucose and Coronary Mortality Over 33 Years in the Whitehall Study
Eric J. Brunner , PHD ,
Martin J. Shipley , MSC ,
Daniel R. Witte , PHD ,
John H. Fuller , MRCP and
Michael G. Marmot , FRCP
From the Department of Epidemiology and Public Health, University College London, London, U.K
Address correspondence and reprint requests to Eric J. Brunner, PhD, 1-19 Torrington Pl., London WC1E 6BT, England. E-mail:
e.brunner{at}ucl.ac.uk
Abstract
OBJECTIVE —Glucose intolerance is a risk factor for coronary disease, but there is uncertainty about the shape of the dose-response
relationship between glucose level and risk of coronary mortality. We examined the prospective relation of 2-h postload blood
glucose (2hBG) with coronary and other major causes of mortality over 33 years.
RESEARCH DESIGN AND METHODS —A 50-g oral glucose tolerance test (OGTT) was performed at baseline (1967–1969) in 17,869 male civil servants aged 40–64
years.
RESULTS —There were 3,561 coronary deaths during 451,787 person-years of observation. All-cause, cardiovascular, and respiratory mortality
were elevated among participants with glucose intolerance. The hazard of coronary mortality rose from 2hBG = 4.6 mmol/l (83
mg/dl [95% CI 4.2–5.3]). The dose-response relation was best fitted by a single slope above this level, with no evidence of
nonlinearity, compared with Cox models using other threshold levels, and those containing log 2hBG terms. There was no evidence
for a dose-response relationship below 2hBG = 4.6 mmol/l. Between this level and 11.1 mmol/l (200 mg/dl), the age-adjusted
hazard ratio was 3.62 (95% CI 2.3–5.6). The graded relationship was attenuated by 45% after adjustment for baseline coronary
heart disease (CHD), BMI, systolic blood pressure, blood cholesterol, smoking, physical activity, lung function, and employment
grade.
CONCLUSIONS —A threshold model with linear slope best described the dose-response relationship between postload blood glucose and CHD
mortality risk.
2hBG, 2-h postload blood glucose
CHD, coronary heart disease
CVD, cardiovascular disease
OGTT, oral glucose tolerance test
Footnotes
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
Accepted October 3, 2005.
Received July 27, 2005.
DIABETES CARE