The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years

Diabetes Care. 1999 Feb;22(2):233-40. doi: 10.2337/diacare.22.2.233.

Abstract

Objective: To assess the relationship between nondiabetic glucose levels and cardio vascular risk.

Research design and methods: Three independent searches using MEDLINE (1966-1996), followed by a manual search of the references from each retrieved article, were conducted by two physicians and one medical librarian. Data had to be reported in at least three quantiles or intervals so that the nature of the relationship between glucose and cardiovascular events (i.e., linear or nonlinear) could be explored, and to ensure that any incremental cardiovascular risk was consistent across quantiles or intervals.

Results: Analyzed studies comprised 95,783 people (94% male) who had 3,707 cardiovascular events over 12.4 years (1,193,231 person-years). Studies reporting fasting glucose levels (n = 6), 2-h glucose levels (n = 7), 1-h glucose levels (n = 5), and casual glucose levels (n = 4) were included. The glucose load used varied from 50 to 100 g. The highest glucose interval for most studies included glucose values in the diabetic range. The relationship between glucose levels and the risk of a cardiovascular event was modeled for each study and the beta-coefficients were combined. Compared with a glucose level of 4.2 mmol/l (75 mg/dl), a fasting and 2-h glucose level of 6.1 mmol/dl (110 mg/dl) and 7.8 mmol/l (140 mg/dl) was associated with a relative cardiovascular event risk of 1.33 (95% CI 1.06-1.67) and 1.58 (95% CI 1.19-2.10), respectively.

Conclusions: The progressive relationship between glucose levels and cardiovascular risk extends below the diabetic threshold.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / analysis
  • Blood Glucose / metabolism*
  • Cardiovascular Diseases / epidemiology*
  • Diabetes Complications
  • Diabetes Mellitus / epidemiology
  • Female
  • Glucose Intolerance / complications
  • Glucose Intolerance / epidemiology*
  • Glucose Tolerance Test
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Regression Analysis

Substances

  • Blood Glucose