Department of Medicine C, Sheba Medical Center, Tel Hashomer, Israel.
Am Heart J. 2012 Jul;164(1):111-6. doi: 10.1016/j.ahj.2012.03.023.
Diabetes mellitus and impaired glucose metabolism are associated with increased risk for cardiovascular disease (CVD). However, it is still not clear whether glucose levels can predict CVD risk among patients without diabetes. The primary aim of this study is to assess whether normoglycemic fasting plasma glucose (FPG) is associated with increased risk of CVD outcomes in healthy patients.
We obtained blood measurements, data from physical examination, and medical and lifestyle information from 10,913 men and women who were evaluated in the Institute for Preventive Medicine of Sheba Medical Center. Enrolled were participants with FPG <100 mg/dL as well as 100 to 125 mg/dL, who were free of diagnosis of CVD. The participants were actively screened for coronary disease using a stress test. Primary end points were coronary heart disease or self-reported cerebral vascular disease.
A total of 1,119 incident cases of CVD occurred during a mean follow-up of 4.3 years. Subjects with fasting glucose levels in the high normal range (95-99 mg/dL) had an increased CVD risk when compared with levels <80 mg/dL, (HR 1.53;CI 95% [1.22-1.91], P < .001). A multivariate model, adjusted for age, sex, family history of CVD, blood pressure, body mass index, smoking status, pharmacologic treatment, serum triglycerides, and high-density lipoprotein and low-density lipoprotein cholesterol levels, revealed an independent increased risk of CVD with rising FPG levels in the normal range.
Elevated CVD risk is strongly and independently associated with glucose levels within the normoglycemic range. Fasting plasma glucose may help in identifying apparently healthy persons with early metabolic abnormalities who are at increased risk for CVD before progression to prediabetes and overt diabetes mellitus.
糖尿病和葡萄糖代谢受损与心血管疾病（CVD）风险增加有关。然而，目前尚不清楚血糖水平是否可以预测无糖尿病患者的 CVD 风险。本研究的主要目的是评估正常空腹血糖（FPG）是否与健康患者 CVD 结局风险增加相关。
我们从谢巴医疗中心预防医学研究所评估的 10913 名男性和女性中获得了血液测量值、体格检查数据以及医疗和生活方式信息。纳入的参与者 FPG<100mg/dL 以及 100-125mg/dL，且无 CVD 诊断。参与者通过压力测试积极筛查冠心病。主要终点为冠心病或自述脑血管疾病。
在平均 4.3 年的随访中，共发生 1119 例 CVD 事件。与 FPG<80mg/dL 相比，空腹血糖水平处于高正常范围（95-99mg/dL）的受试者发生 CVD 的风险增加（HR 1.53；95%CI [1.22-1.91]，P<.001）。多变量模型调整了年龄、性别、CVD 家族史、血压、体重指数、吸烟状况、药物治疗、血清甘油三酯、高密度脂蛋白和低密度脂蛋白胆固醇水平，结果显示在正常范围内，随着 FPG 水平升高，CVD 风险独立增加。
在正常血糖范围内，升高的 CVD 风险与血糖水平密切相关且独立相关。空腹血糖可能有助于识别在进展为糖尿病前期和显性糖尿病之前，代谢异常早期且 CVD 风险增加的看似健康人群。
