Nam Hoon Kim1, Tae Yeon Kwon1, Sungwook Yu1, Nan Hee Kim1, Kyung Mook Choi1, Sei Hyun Baik1, Yousung Park1, Sin Gon Kim2. 1. From the Division of Endocrinology and Metabolism, Department of Internal Medicine (Nam Hoon Kim, Nan Hee Kim, K.M.C., S.H.B., S.G.K.) and Department of Neurology (S.Y.), Korea University College of Medicine, Seoul, Korea; Division of International Finance, Hankuk University of Foreign Studies, Seoul, Korea (T.Y.K.); and Department of Statistics, Korea University, Seoul, Korea (Y.P.). 2. From the Division of Endocrinology and Metabolism, Department of Internal Medicine (Nam Hoon Kim, Nan Hee Kim, K.M.C., S.H.B., S.G.K.) and Department of Neurology (S.Y.), Korea University College of Medicine, Seoul, Korea; Division of International Finance, Hankuk University of Foreign Studies, Seoul, Korea (T.Y.K.); and Department of Statistics, Korea University, Seoul, Korea (Y.P.). k50367@korea.ac.kr yspark433@gmail.com.
Abstract
BACKGROUND AND PURPOSE: Prediabetes is a known risk factor for vascular diseases; however, its differential contribution to mortality risk from various vascular disease subtypes is not known. METHODS: The subjects of the National Health Insurance Service in Korea (2002-2013) nationwide cohort were stratified into normal glucose tolerance (fasting glucose <100 mg/dL), impaired fasting glucose (IFG) stage 1 (100-109 mg/dL), IFG stage 2 (110-125 mg/dL), and diabetes mellitus groups based on the fasting glucose level. A Cox regression analysis with counting process formulation was used to assess the mortality risk for vascular disease and its subtypes-ischemic heart disease, ischemic stroke, and hemorrhagic stroke. RESULTS: When adjusted for age, sex, and body mass index, IFG stage 2, but not stage 1, was associated with significantly higher all-cause mortality (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.18-1.34) and vascular disease mortality (HR, 1.27; 95% CI, 1.08-1.49) compared with normal glucose tolerance. Among the vascular disease subtypes, mortality from ischemic stroke was significantly higher (HR, 1.60; 95% CI, 1.18-2.18) in subjects with IFG stage 2 but not from ischemic heart disease and hemorrhagic stroke. The ischemic stroke mortality associated with IFG stage 2 remained significantly high when adjusted other modifiable vascular disease risk factors (HR, 1.51; 95% CI: 1.10-2.09) and medical treatments (HR, 1.75; 95% CI, 1.19-2.57). CONCLUSIONS: Higher IFG degree (fasting glucose, 110-125 mg/dL) was associated with increased all-cause and vascular disease mortality. The increased vascular disease mortality in IFG stage 2 was attributable to ischemic stroke, but not ischemic heart disease or hemorrhagic stroke in Korean adults.
BACKGROUND AND PURPOSE:Prediabetes is a known risk factor for vascular diseases; however, its differential contribution to mortality risk from various vascular disease subtypes is not known. METHODS: The subjects of the National Health Insurance Service in Korea (2002-2013) nationwide cohort were stratified into normal glucose tolerance (fasting glucose <100 mg/dL), impaired fasting glucose (IFG) stage 1 (100-109 mg/dL), IFG stage 2 (110-125 mg/dL), and diabetes mellitus groups based on the fasting glucose level. A Cox regression analysis with counting process formulation was used to assess the mortality risk for vascular disease and its subtypes-ischemic heart disease, ischemic stroke, and hemorrhagic stroke. RESULTS: When adjusted for age, sex, and body mass index, IFG stage 2, but not stage 1, was associated with significantly higher all-cause mortality (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.18-1.34) and vascular disease mortality (HR, 1.27; 95% CI, 1.08-1.49) compared with normal glucose tolerance. Among the vascular disease subtypes, mortality from ischemic stroke was significantly higher (HR, 1.60; 95% CI, 1.18-2.18) in subjects with IFG stage 2 but not from ischemic heart disease and hemorrhagic stroke. The ischemic stroke mortality associated with IFG stage 2 remained significantly high when adjusted other modifiable vascular disease risk factors (HR, 1.51; 95% CI: 1.10-2.09) and medical treatments (HR, 1.75; 95% CI, 1.19-2.57). CONCLUSIONS: Higher IFG degree (fasting glucose, 110-125 mg/dL) was associated with increased all-cause and vascular disease mortality. The increased vascular disease mortality in IFG stage 2 was attributable to ischemic stroke, but not ischemic heart disease or hemorrhagic stroke in Korean adults.
Authors: Katherine A Pratte; Ann Johnson; Janette Beals; Ann Bullock; Spero M Manson; Luohua Jiang Journal: Diabetes Care Date: 2019-06-08 Impact factor: 19.112