The Association between HbA1c, Fasting Glucose, 1-Hour Glucose and 2-Hour Glucose during an Oral Glucose Tolerance Test and Cardiovascular Disease in Individuals with Elevated Risk for Diabetes
Artikel i vetenskaplig tidskrift, 2014

Objective: To determine the association between HbA1c, fasting plasma glucose (FPG), 1-hour (1 hPG) and 2-hour (2 hPG) glucose after an oral glucose tolerance test (OGTT) and cardiovascular disease in individuals with elevated risk for diabetes. Design: We studied the relationship between baseline, updated mean and updated (last) value of HbA1c, FPG, 1 hPG and 2 hPG after an oral 75 g glucose tolerance test (OGTT) and acute CVD events in 504 individuals with impaired glucose tolerance (IGT) at baseline enrolled in the Finnish Diabetes Prevention Study. Participants: 504 individuals with IGT were followed with yearly evaluations with OGTT, FPG and HbA1c. Results: Over a median follow-up of 9.0 years 34 (6.7%) participants had a CVD event, which increased to 52 (10.3%) over a median follow-up of 13.0 years when including events that occurred among participants following a diagnosis of diabetes. Updated mean HbA1c, 1 hPG and 2 hPG, HR per 1 unit SD of 1.57 (95% CI 1.16 to 2.11), p = 0.0032, 1.51 (1.03 to 2.23), p = 0.036 and 1.60 (1.10 to 2.34), p = 0.014, respectively, but not FPG (p = 0.11), were related to CVD. In analyses of the last value prior to the CVD event the same three glycaemic measurements were associated with the CVD events, with HRs per 1 unit SD of 1.45 (1.06 to 1.98), p = 0.020, 1.55 (1.04 to 2.29), p = 0.030 and 2.19 (1.51 to 3.18), p < 0.0001, respectively but only 2 hPG remained significant in pairwise comparisons. Including the follow-up period after diabetes onset updated 2 hPG (p = 0.003) but not updated mean HbA1c (p = 0.08) was related to CVD. Conclusions and Relevance: Current 2 hPG level in people with IGT is associated with increased risk of CVD. This supports its use in screening for prediabetes and monitoring glycaemic levels of people with prediabetes.

Författare

Marcus Lind

Göteborgs universitet

J. Tuomilehto

Donau-Universitat Krems

National Institute for Health and Welfare

M. Uusitupa

Ita-Suomen yliopisto

Olle Nerman

Chalmers, Matematiska vetenskaper, matematisk statistik

Göteborgs universitet

J. Eriksson

National Institute for Health and Welfare

Helsingin Yliopisto

Folkhalsan

Helsinki University Central Hospital

P. Ilanne-Parikka

Finnish Diabetes Association

S. Keinanen-Kiukaanniemi

Oulu University Hospital

Oulun Yliopisto

M. Peltonen

National Institute for Health and Welfare

A. Pivodic

J. Lindstrom

National Institute for Health and Welfare

PLoS ONE

1932-6203 (ISSN)

Vol. 9 e109506- e109506

Ämneskategorier

Klinisk medicin

DOI

10.1371/journal.pone.0109506