Postchallenge hyperglycemia and mortality in a national sample of U.S. adults.

Abstract

OBJECTIVE:

Although postchallenge hyperglycemia is a well-established feature of type 2 diabetes, its association with risk of mortality is uncertain. Therefore, the aim of this study was to assess the independent association of fasting and 2-h glucose levels with all-cause and cardiovascular disease (CVD) mortality.

RESEARCH DESIGN AND METHODS:

We analyzed data from the Second National Health and Nutrition Examination Survey (NHANES II) Mortality Study, a prospective cohort study of U.S. adults examined in the NHANES II, and focused on the 3,092 adults aged 30-74 years who underwent an oral glucose tolerance test at baseline (1976-1980). Deaths were identified from U.S. national mortality files from 1976 to 1992. To account for the complex survey design, we used SUDAAN statistical software for weighted analysis.

RESULTS:

Compared with their normoglycemic counterparts (fasting glucose [FG] < 7.0 and 2-h glucose < 7.8 mmol/l), adults with fasting and postchallenge hyperglycemia (FG > or =7.0 and 2-h glucose > or =11.1 mmol/l) had a twofold higher risk of death after 16 years of follow-up (age- and sex-adjusted relative hazard [RH] 2.1, 95% CI 1.4-3.2). However, adults with isolated postchallenge hyperglycemia (FG < 7.0 and 2-h glucose > or =11.1 mmol/l) were also at higher risk of death (1.6, 1.0-2.6). In proportional hazards analysis, FG (fully adjusted RH 1.10 per 1 SD; 95% CI 1.01, 1.22) and 2-h glucose (1.14, 1.00-1.29) showed nearly identical predictive value for mortality. Similar trends were observed for CVD mortality.

CONCLUSIONS:

These results suggest that postchallenge hyperglycemia is associated with increased risk of all-cause and CVD mortality independently of other CVD risk factors.

• Authors: S H Saydah, M Miret, J Sung, C Varas, D Gause, F L Brancati
• Journal: Diabetes care (Diabetes Care) Vol. 24 Issue 8 Pg. 1397-402 (Aug 2001) ISSN: 0149-5992 [Print] United States
• PMID: 11473076 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Blood Glucose

Topics

• Adult
• Aged
• Blood Glucose (analysis, metabolism)
• Blood Pressure
• Body Mass Index
• Cohort Studies
• Coronary Disease (epidemiology)
• Diabetes Mellitus (epidemiology)
• Educational Status
• Ethnicity
• Female
• Glucose Intolerance (epidemiology, mortality)
• Glucose Tolerance Test
• Humans
• Hyperglycemia (epidemiology, mortality)
• Male
• Middle Aged
• Prospective Studies
• Reference Values
• Smoking
• United States (epidemiology)