Qiao Q, Pyörälä K, Pyörälä M, Nissinen A, Lindström J, Tilvis R, Tuomilehto J
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
Eur Heart J. 2002 Aug;23(16):1267-75. doi: 10.1053/euhj.2001.3113.
To assess the predictive value of fasting and 2-h glucose after a 75 g glucose load, with regard to incidence of coronary heart disease and cardiovascular mortality.
6766 subjects from five Finnish cohorts aged 30-89 years were followed up for 7-10 years. Hazards ratios associated with increasing glucose concentrations were homogeneous over studies. Multivariate Cox regression analyses showed that the hazards ratio for one standard deviation increase in 2-h glucose after logarithmic transformation was 1.17 (95% CI 1.05-1.30) for coronary heart disease incidence and 1.22 (1.09-1.37) for cardiovascular mortality. For fasting glucose, they were 1.05 (0.94-1.17) and 1.13 (1.01-1.25), respectively. Inclusion of 2-h glucose in the model based on fasting glucose significantly improved the prediction (P<0.005 for coronary heart disease incidence and P<0.025 for cardiovascular mortality), whereas fasting glucose did not add significant information to the model initially based on 2-h glucose (P>0.10 for both events).
In subjects without a prior history of diabetes the association of 2-h glucose with coronary heart disease incidence and cardiovascular morality is graded and independent. The results of our study indicate that 2-h glucose is superior to fasting glucose in assessing the risk of future cardiovascular disease events.
评估75克葡萄糖负荷后空腹血糖及2小时血糖对于冠心病发病率和心血管疾病死亡率的预测价值。
对来自芬兰五个队列的6766名年龄在30 - 89岁的受试者进行了7至10年的随访。不同研究中，与血糖浓度升高相关的风险比具有同质性。多变量Cox回归分析显示，对数转换后2小时血糖每增加一个标准差，冠心病发病率的风险比为1.17（95%可信区间1.05 - 1.30），心血管疾病死亡率的风险比为1.22（1.09 - 1.37）。空腹血糖的相应风险比分别为1.05（0.94 - 1.17）和1.13（1.01 - 1.25）。在基于空腹血糖的模型中纳入2小时血糖可显著改善预测效果（冠心病发病率P<0.005，心血管疾病死亡率P<0.025），而空腹血糖在最初基于2小时血糖的模型中并未增加显著信息（两种情况P>0.10）。
在无糖尿病病史的受试者中，2小时血糖与冠心病发病率及心血管疾病死亡率的关联呈分级且独立。我们的研究结果表明，在评估未来心血管疾病事件风险方面，2小时血糖优于空腹血糖。
