Association between fasting glucose and all-cause mortality according to sex and age: a prospective cohort study

Abstract

The association of fasting glucose with the risk of death according to sex and age remains unclear, and insufficient information is available on sex- and age-specific glucose concentrations within ethnic groups. This study analyzed a sample of 12,455,361 Korean adults who participated in health examinations during 2001–2004, and were followed up until 2013. Men had 3.0 mg/dL (0.167 mmol/L) higher mean glucose concentrations than women (94.7 vs. 91.7 mg/dL), although women over 73 years had higher levels. For glucose levels of 100–199 mg/dL, each 18 mg/dL (1 mmol/L) increase in fasting glucose increased mortality by 13% (HR = 1.13, [95% CI 1.12 to 1.13], p < 0.001). In individuals with fasting glucose levels of 100–125 mg/dL, each 18 mg/dL increase in fasting glucose was associated with a 30% increase in the risk for mortality (1.30, [1.18 to 1.43]) in those aged 18–34 years, a 32% increase (1.32, [1.26 to 1.39]) in those aged 35–44 years, and a 10% increase (1.10, [1.02 to 1.19]) in those aged 75–99 years. The fasting glucose levels associated with the lowest mortality were 80–94 mg/dL regardless of sex and age. Prediabetes (100–125 mg/dL) was associated with higher mortality. The associations of hyperglycemia with mortality were stronger at younger ages.

Metabolic consequences of gonadotropin‐releasing hormone agonists vs orchiectomy: a randomized clinical study

“…A priori , we calculated that a total sample size of 48 would have an 80% power to demonstrate between‐group differences in the absolute values of fasting plasma glucose of 0.5 mmol/L, with a standard deviation of 0.4 mmol/L and the AG ratio of 0.05 with a standard deviation of 0.06 at the significance level of 5%. The threshold of a meaningful between‐group difference in fasting plasma glucose was based on the clinical judgement of the author group . To allow for a dropout rate of 20%, a total of 58 patients were randomized.…”

Optimal fasting glucose levels with regard to cardiovascular and mortality outcomes in people treated with or without antidiabetic medication

“…A meta‐analysis of 102 prospective studies reported that baseline FBG levels between 5.6 mmol/L and 6.9 mmol/L were associated with higher risk of coronary heart disease . Further, some cohort studies in Asia observed that higher glucose levels, even within the normal range, were associated with higher risk of mortality or CVD . Meanwhile, in a recent analysis of seven cohorts in the United States, an FBG level of 6.2 to 6.9 mmol/L was associated with an increased risk of CVD among men, but not women .…”

“…2 Further, some cohort studies in Asia observed that higher glucose levels, even within the normal range, were associated with higher risk of mortality or CVD. 12,13 Meanwhile, in a recent analysis of seven cohorts in the United States, an FBG level of 6.2 to 6.9 mmol/L was associated with an increased risk of CVD among men, but not women. 14 In the present study, impaired FBG, even within levels 5.6 to 6.0 mmol/L, was associated with poor outcomes, irrespective of age or sex, while the associations were more apparent in adults of normal weight than in overweight adults ( Figure 2).…”

Prediction of incident hypertension and arterial stiffness using the non–insulin‐based metabolic score for insulin resistance (METS‐IR) index

“…Recently, there has been crescent interest in developing non–insulin‐based IR indexes including the TyG index and TG/HDL‐C ratio. Components of such indices, including fasting glucose, triglycerides, and HDL‐C, have been shown predictive of hypertension and CV risk in prospective studies . A significant contribution of hypertension and CVD risk is explained by arterial stiffness, which implies degeneration of elastin fibers and deposition of collagen in arterial walls, inducing structural and functional modifications in the arterial wall .…”

“…Components of such indices, including fasting glucose, triglycerides, and HDL-C, have been shown predictive of hypertension and CV risk in prospective studies. [5][6][7] A significant contribution of hypertension and CVD risk is explained by arterial stiffness, which implies degeneration of elastin fibers and deposition of collagen in arterial walls, inducing structural and functional modifications in the arterial wall. 8 The TyG index and the TG/HDL-C ratio have proven strong and consistent associations with hypertension, CVD risk, and arterial stiffness in several populations, suggesting a potential role for IR assessment in identifying arterial stiffness using non-insulin-based IR surrogates.…”