Hironori Imano1,2, Hiroyasu Iso1, Akihiko Kitamura2,3, Kazumasa Yamagishi4, Mina Hayama-Terada2, Isao Muraki1,2, Takeo Okada2, Mitsumasa Umesawa5, Tetsuya Ohira6, Tomoko Sankai7, Renzhe Cui1, Takeshi Tanigawa8, Masahiko Kiyama2. 1. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine. 2. Osaka Center for Cancer and Cardiovascular Disease Prevention. 3. Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology. 4. Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba. 5. Department of Public Health, Dokkyo Medical University School of Medicine. 6. Department of Epidemiology, Fukushima Medical University. 7. Department of Community Health, Faculty of Medicine, University of Tsukuba. 8. Department of Public Health, Juntendo University School of Medicine.
Abstract
BACKGROUND: The effect of postprandial glucose on the risk of cardiovascular disease has been emphasized, but it is controversial whether nonfasting glucose is related to incident stroke and its types.Methods and Results: We investigated the associations of nonfasting glucose with incident stroke and its types among 7,198 participants aged 40-74 years from the Circulatory Risk in Communities Study, enrolled in 1995-2000. We estimated multivariable hazard ratios (HR) using Cox proportional hazard models. Over a median follow-up of 14.1 years, 291 cases of total stroke (ischemic strokes: 191 including 109 lacunar infarctions) were identified. Nonfasting glucose concentration was associated with greater risk of incident total stroke, ischemic stroke and lacunar infarction when modeled categorically (for prediabetic type: 7.8-11.0 mmol/L vs. normal type: <7.8 mmol/L among all subjects, HR for lacunar infarction was 2.02, 95% confidence interval (CI): 1.19, 3.43) or continuously (per one standard deviation increment among all subjects, HR for lacunar infarction was 1.29, 95% CI: 1.15, 1.45). Diabetic type showed similar results. Population attributable fractions of nonfasting hyperglycemia were 13.2% for ischemic stroke and 17.4% for lacunar infarction. CONCLUSIONS: Nonfasting glucose concentration, either as a diagnosis of prediabetic and diabetic types or as a continuous variable, proved to be an independent predictor significantly attributed to incident total stroke, especially ischemic stroke and lacunar infarction, in the general population.
BACKGROUND: The effect of postprandial glucose on the risk of cardiovascular disease has been emphasized, but it is controversial whether nonfasting glucose is related to incident stroke and its types.Methods and Results: We investigated the associations of nonfasting glucose with incident stroke and its types among 7,198 participants aged 40-74 years from the Circulatory Risk in Communities Study, enrolled in 1995-2000. We estimated multivariable hazard ratios (HR) using Cox proportional hazard models. Over a median follow-up of 14.1 years, 291 cases of total stroke (ischemic strokes: 191 including 109 lacunar infarctions) were identified. Nonfasting glucose concentration was associated with greater risk of incident total stroke, ischemic stroke and lacunar infarction when modeled categorically (for prediabetic type: 7.8-11.0 mmol/L vs. normal type: <7.8 mmol/L among all subjects, HR for lacunar infarction was 2.02, 95% confidence interval (CI): 1.19, 3.43) or continuously (per one standard deviation increment among all subjects, HR for lacunar infarction was 1.29, 95% CI: 1.15, 1.45). Diabetic type showed similar results. Population attributable fractions of nonfasting hyperglycemia were 13.2% for ischemic stroke and 17.4% for lacunar infarction. CONCLUSIONS: Nonfasting glucose concentration, either as a diagnosis of prediabetic and diabetic types or as a continuous variable, proved to be an independent predictor significantly attributed to incident total stroke, especially ischemic stroke and lacunar infarction, in the general population.
Authors: Hertzel C Gerstein; Eric E Smith; Chinthanie Ramasundarahettige; Dipika Desai; Philip Awadalla; Philippe Broet; Sandra Black; Trevor J B Dummer; Jason Hicks; Alan Moody; Jean-Claude Tardif; Koon K Teo; Jennifer Vena; Salim Yusuf; Douglas S Lee; Matthias G Friedrich; Sonia S Anand Journal: J Clin Endocrinol Metab Date: 2021-01-23 Impact factor: 5.958
Authors: Paul Mackie; Ishanka Weerasekara; Gary Crowfoot; Heidi Janssen; Elizabeth Holliday; David Dunstan; Coralie English Journal: PLoS One Date: 2019-06-13 Impact factor: 3.240