Is Nondiabetic Hyperglycemia a Risk Factor for Cardiovascular Disease?

Levitan, Emily B.; Song, Yiqing; Ford, Earl S.; Liu, Simin

doi:10.1001/archinte.164.19.2147

Cited by 601 publications

(414 citation statements)

References 60 publications

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“…This may represent potential harm to PD patients, since HbA1c has been strongly associated with a high risk for diabetes, CV disease and all cause mortality in general non-diabetic patients and CKD patients. [1][2][3]13 Although HbA1c it's not considered the ideal method to evaluate glycaemic control in the uremic setting, 14,15 it is still widely available and can be an useful tool to compare groups and stratify those at high risk. Its ideal levels are still not established.…”

Section: Discussionmentioning

confidence: 99%

“…Recent reports suggest that the relationship between hyperglycemia and cardiovascular disease (CVD) may extend below the limits currently defined as diabetes, since higher levels of glycosylated hemoglobin (HbA1c) are independent predictors of mortality in general population and non-diabetic CKD patients. [1][2][3] Insulin resistance was also identified as an independent predictor of cardiovascular events and mortality in general and CKD patients. 4,5 The initiation of peritoneal dialysis (PD) represents an additional risk to glucose metabolism, due to the absorption of dextrose contained in the dialysate, which potentially intensifies carbohydrate disturbances 6 .…”

Section: Introductionmentioning

confidence: 99%

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Comparative analysis of lipid and glucose metabolism biomarkers in non-diabetic hemodialysis and peritoneal dialysis patients

Fortes¹,

Ribeiro²,

Riella³

et al. 2011

J. Bras. Nefrol.

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ResumoObjetivo: O presente estudo foi desenhado pra investigar e comparar biomarcadores do metabolismo de glicose e lipídeos em pacientes não diabéticos em diálise peritoneal e hemodiálise. Métodos: O estudo possui um desenho prospectivo e transversal. Participantes: foram incluídos todos os pacientes prevalentes em terapia de substituição renal tratados em uma clíni-ca universitária. Intervenções: não houve intervenções. Medida das variáveis principais: as amostras de sangue foram coletadas com jejum oral de 8 horas. Os níveis séricos de insulina foram determinados por quimioluminescência. Resistência insulínica foi avaliada pelo index QUICKI como se segue: 1/[log(Io) + log(Go)], onde Io é a insulina de jejum, e Go a glicemia de jejum. Índice HOMA também foi medido: (FPG × FPI)/22,5; FPG = glicemia de jejum (mmol/L); FPI = insulina de jejum (mU/mL). Os demais exames bioquímicos foram analisados utilizando métodos de rotina. Resultados: Foram avaliados 154 pacientes (80 em hemodiálise e 74 em diálise peritoneal). Setenta e quatro pacientes diabéticos foram excluídos. Dos 80 pacientes restantes (55% homens, idade média de 52 ± 15 anos), 35 estavam em diálise peritoneal e 45 em hemodiálise. A glicemia em jejum dos pacientes em diáli-se peritoneal em relação à hemodiálise foi 5,0 ± 0,14 versus 4,58 ± 0,14 mmol/L, p < 0,05; para hemoglobina glicada (HbA1c) de 5,9 ± 0,1 versus 5,5 ± 0,1%, p<0,05; colesterol total de 5,06 ± 0,19 versus 3,39 ± 0,20 mmol/L, p < 0,01; LDL-c de 2,93 ± 0,17 versus 1,60 ± 0,17 mmol/L, p < 0,01; e índice HOMA de 3,27 versus 1,68, p < 0,05. Todas as variáveis foram ajustadas para idade, sexo, tempo em diálise, produto cálcio-fósforo, albumina e proteína

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative analysis of lipid and glucose metabolism biomarkers in non-diabetic hemodialysis and peritoneal dialysis patients

Fortes¹,

Ribeiro²,

Riella³

et al. 2011

J. Bras. Nefrol.

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“…Impaired glucose tolerance and diabetes mellitus are wellknown risk factors for coronary heart disease (CHD) and cardiovascular disease (CVD) [1][2][3][4]. A fasting blood glucose level or a fasting blood glucose level plus 2 h post-glucose load (75 g OGTT) are usually used to diagnose diabetes mellitus [5].…”

Section: Introductionmentioning

confidence: 99%

Relationship of elevated casual blood glucose level with coronary heart disease, cardiovascular disease and all-cause mortality in a representative sample of the Japanese population. NIPPON DATA80

et al. 2008

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Aims/hypothesis High fasting blood glucose is one of the well-known risk factors for CHD. However, in certain settings, patients cannot always be expected to fast. For example, community screenings for cardiovascular disease (CVD) risk factors in Japan are performed under non-fasting conditions to achieve high participation rates. Thus, we examined a representative cohort of the Japanese population (n=9,444, follow-up period 17.3 years) to clarify whether high casual blood glucose (CBG) can predict CVD mortality. Methods We defined CBG groups as follows: high CBG≥ 11.1 mmol/l or participants with a history of diabetes mellitus; borderline high, 7.77≤CBG<11.1 mmol/l; higher normal, 5.22≤CBG<7.77 mmol/l); and lower normal, CBG<5.22 mmol/l. The multivariate-adjusted hazard ratios (HRs) for CHD, CVD and all-cause mortality were calculated. Results The crude CHD mortality rate was 0.84 per 1,000 person-years. Age-and sex-adjusted HRs for CHD mortality were high among participants with CBG levels ≥7.77 mmol/l, regardless of time since last meal. Multivariate-adjusted HRs (95% CI) of CHD mortality in high and borderline high CBG groups were 2.62 (1.46-4.67) and 2.43 (1.29-4.58), respectively. Similar results were observed for both CVD Diabetologia (2008) and all-cause mortality. Even within the normal blood glucose range, each 1 mmol/l increase in CBG was associated with a statistically significant increase in the HR for CVD mortality (1.12, 95% CI 1.02-1.22). Population-attributable fractions of the combined groups of high and borderline high CBG for CHD, CVD and all-cause mortality were 12.0, 4.9 and 3.5%, respectively. Conclusions/interpretation Increases in CBG, even within the normal range, predict CVD mortality.51:575-582 DOI 10.1007/s00125-007-0915-6 Electronic supplementary

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“…Other studies showed that familial aggregation of type 2 diabetes also relates to the presence of cardiometabolic abnormalities in children [4][5][6][7][8]. CVD and type 2 diabetes often co-occur [3,9,10] and share risk factors such as hypertension, overweight, unhealthy diet and lack of physical activity. However, previous studies assessing cardiometabolic markers in children lacked data on family history of both CVD and diabetes, and it is unclear whether CVD and diabetes history are independently associated with cardiometabolic markers in children.…”

Section: Introductionmentioning

confidence: 99%

Family history of myocardial infarction, stroke and diabetes and cardiometabolic markers in children

et al. 2016

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Aims/hypothesis Despite the overlap in occurrence of cardiovascular disease (CVD) and type 2 diabetes and their risk factors, family history of these diseases has not yet been investigated simultaneously in relation to cardiometabolic markers in offspring. We examined how a family history of CVD and/or diabetes relates to cardiometabolic markers in offspring, and to what extent these diseases independently contribute to cardiometabolic markers. Methods We used data from 1,374 12-year-old children and their parents participating in a birth cohort study in the Netherlands. Family history of CVD (myocardial infarction [MI] and stroke) and diabetes were reported by the parents. Children were classified as 'no', 'moderate' or 'strong' family history, based on early/late onset of disease in parents and grandparents. Cardiometabolic markers were measured at 12 years of age: waist circumference, cholesterol, blood pressure and HbA 1c .Results Compared with those with no family history, children with a strong family history of MI and/or stroke and/or diabetes (29% of the study population) had 0.13 mmol/l higher total cholesterol (TC) (95% CI 0.03, 0.23) and 0.18 higher TC/ HDL-cholesterol (HDLC) ratio (95% CI 0.04, 0.32). A strong family history of MI or diabetes was independently associated with unfavourable cardiometabolic markers specific to those diseases. These associations remained after adjusting for BMI. Children with a moderate family history had no unfavourable cardiometabolic markers. Conclusions/interpretation One-third of the children had a strong family history of CVD and/or diabetes. These children had higher TC levels and TC/HDLC ratios than children with no family history. A strong family history of MI or diabetes was independently associated with unfavourable cardiometabolic markers specific to those diseases.

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Is Nondiabetic Hyperglycemia a Risk Factor for Cardiovascular Disease?

Abstract: Blood glucose level is a risk marker for CVD among apparently healthy individuals without diabetes.

Cited by 601 publications

References 60 publications

Comparative analysis of lipid and glucose metabolism biomarkers in non-diabetic hemodialysis and peritoneal dialysis patients

Comparative analysis of lipid and glucose metabolism biomarkers in non-diabetic hemodialysis and peritoneal dialysis patients

Relationship of elevated casual blood glucose level with coronary heart disease, cardiovascular disease and all-cause mortality in a representative sample of the Japanese population. NIPPON DATA80

Family history of myocardial infarction, stroke and diabetes and cardiometabolic markers in children

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