Non-linear contribution of glucose measures to cardiovascular diseases and mortality: reclassifying the Framingham's risk categories: a decade follow-up from the Tehran lipid and glucose study

International Journal of Cardiology
Homa YadegariF Azizi

Abstract

We investigated non-linear contribution of fasting plasma glucose (FPG) and 2-hour post-challenge plasma glucose (2h-PCPG) to the risk of CVD and mortality. We hypothesized that glucose measures improve risk-stratification made by the Framingham's general CVD risk algorithm. Among participants aged ≥ 30 (n=8071), not taking glucose-lowering agents, 6169 (3477 women) remained eligible. Non-linear contribution of FPG and 2h-PCPG to incident CVD and mortality were assessed using Cox models incorporating restricted cubic splines functions. Risk reclassification improvement conferred by FPG and 2h-PCPG was examined using an extended version of net reclassification index (NRI) that takes into account the censoring nature of survival data. We documented 465 incident CVD events (402 CHD), 212 deaths from any cause (94 CVD deaths). Excluding the contribution of the 2h-PCGP to mortality (that was linear) dose-response relationships between glucose measures and CVD and mortality were curvilinear with nadirs below which decreasing levels of glucose were unlikely to offer any benefit. These nadirs were assigned to FPG of 4.9-5.3 and 2h-PCPG of 6.0 mmol.l(-1). Glucose measures added to the predictive ability of the Framingham's general CVD r...Continue Reading

References

Jun 18, 1999·Diabetes Care·R C Perry, A D Baron
Apr 24, 2001·Diabetes Care·UNKNOWN American Diabetes Association
Jun 29, 2002·BMJ : British Medical Journal·M R Law, N J Wald
Sep 28, 2002·Diabetes Care·James B MeigsUNKNOWN Framingham Offspring Study
Dec 28, 2002·Diabetes Care·UNKNOWN Expert Committee on the Diagnosis and Classification of Diabetes Mellitus
Nov 25, 2004·Diabetes Care·C M M LawesUNKNOWN Asia Pacific Cohort Studies Collaboration
Dec 17, 2005·Diabetes & Metabolism·P E Wändell, H Theobald
Jul 29, 2006·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Farzad HadaeghFereidoun Azizi
Sep 23, 2006·European Journal of Endocrinology·G Neil ThomasUNKNOWN Hong Kong Cardiovascular Risk Factor Prevalence Study Steering Committee
May 31, 2007·Revista española de cardiología·Lars RydénInga Thrainsdottir
Jan 27, 2009·Trials·Fereidoun AziziUNKNOWN Tehran Lipid and Glucose Study Group
Feb 4, 2009·Circulation·Joohon SungDebbie A Lawlor
Jul 1, 2009·Diabetes Care·James B Meigs

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Citations

Jun 10, 2016·International Journal of Endocrinology and Metabolism·Mahnaz BarkhordariMohammadreza Bozorgmanesh
Jan 7, 2017·International Journal of Endocrinology and Metabolism·Mahnaz BarkhordariMohammadreza Bozorgmanesh

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