Longitudinal change in fasting blood glucose and myocardial infarction risk in a population without diabetes

Cheng Jin, Shuohua Chen, Anand Vaidya, Yuntao Wu, Zhijun Wu, Frank B. Hu, Penny Kris-Etherton, Shouling Wu, Xiang Gao

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

OBJECTIVE To examine the change in fasting blood glucose (FBG) during repeated assessments over time and its potential impact on the risk of developing myocardial infarction (MI). RESEARCH DESIGN AND METHODS This prospective cohort study included 68,297 participants without diabetes (mean age 49 years) whowere free ofMI, stroke, and cancer prior to or in 2010 (baseline of the current analysis). FBG concentrations were measured in 2006, 2008, and 2010. The FBG trajectories during 2006-2010, the primary exposure of the current study, were identified by latent mixture modeling. Incident MI cases were confirmed via review of medical records by cardiologists. RESULTS We identified five discrete FBG trajectories according to FBG range and changing pattern over time: elevated-stable (n = 3,877), elevated-decreasing (n = 7,060), moderate-increasing (n = 10,298), moderate-stable (n = 40,352), and low-stable (n = 6,710). During 4 years of follow-up, we documented 283 incident MI cases. Relative to the moderate-stable pattern (FBG ranged from 4.9 to 5.1 mmol/L), adjusted hazard ratios (HRs) were 1.53 (95% CI 1.04, 2.26) for the elevated-stable pattern (FBG ranged from 6.1 to 6.3 mmol/L) and HR 0.61 (95% CI 0.38, 0.98) for the elevated-decreasing pattern (FBG decreased from 6.0 to 5.4 mmol/L), after adjustment for potential confounders such as age, sex, lifestyle factors, obesity, medical history, blood pressure, blood lipids, and C-reactive protein. Consistently, cumulative average and increasing rate of FBG during 2006-2010, but not a single baseline FBG, predicted future risk of MI. CONCLUSIONS We found that discrete FBG trajectories were significantly associated with subsequent risk of MI in individuals without diabetes. These observations suggest that long-term trajectories of FBG may be important for risk prediction of MI and possibly other macrovascular diseases.

Original languageEnglish (US)
Pages (from-to)1565-1572
Number of pages8
JournalDiabetes care
Volume40
Issue number11
DOIs
StatePublished - Nov 1 2017

Fingerprint

Blood Glucose
Fasting
Myocardial Infarction
Population
Sex Factors
C-Reactive Protein
Medical Records
Life Style
Cohort Studies
Research Design
Obesity
Stroke
Prospective Studies
Blood Pressure
Lipids

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Jin, Cheng ; Chen, Shuohua ; Vaidya, Anand ; Wu, Yuntao ; Wu, Zhijun ; Hu, Frank B. ; Kris-Etherton, Penny ; Wu, Shouling ; Gao, Xiang. / Longitudinal change in fasting blood glucose and myocardial infarction risk in a population without diabetes. In: Diabetes care. 2017 ; Vol. 40, No. 11. pp. 1565-1572.
@article{dc9394fef4ec45f6ab068b632f4fda7c,
title = "Longitudinal change in fasting blood glucose and myocardial infarction risk in a population without diabetes",
abstract = "OBJECTIVE To examine the change in fasting blood glucose (FBG) during repeated assessments over time and its potential impact on the risk of developing myocardial infarction (MI). RESEARCH DESIGN AND METHODS This prospective cohort study included 68,297 participants without diabetes (mean age 49 years) whowere free ofMI, stroke, and cancer prior to or in 2010 (baseline of the current analysis). FBG concentrations were measured in 2006, 2008, and 2010. The FBG trajectories during 2006-2010, the primary exposure of the current study, were identified by latent mixture modeling. Incident MI cases were confirmed via review of medical records by cardiologists. RESULTS We identified five discrete FBG trajectories according to FBG range and changing pattern over time: elevated-stable (n = 3,877), elevated-decreasing (n = 7,060), moderate-increasing (n = 10,298), moderate-stable (n = 40,352), and low-stable (n = 6,710). During 4 years of follow-up, we documented 283 incident MI cases. Relative to the moderate-stable pattern (FBG ranged from 4.9 to 5.1 mmol/L), adjusted hazard ratios (HRs) were 1.53 (95{\%} CI 1.04, 2.26) for the elevated-stable pattern (FBG ranged from 6.1 to 6.3 mmol/L) and HR 0.61 (95{\%} CI 0.38, 0.98) for the elevated-decreasing pattern (FBG decreased from 6.0 to 5.4 mmol/L), after adjustment for potential confounders such as age, sex, lifestyle factors, obesity, medical history, blood pressure, blood lipids, and C-reactive protein. Consistently, cumulative average and increasing rate of FBG during 2006-2010, but not a single baseline FBG, predicted future risk of MI. CONCLUSIONS We found that discrete FBG trajectories were significantly associated with subsequent risk of MI in individuals without diabetes. These observations suggest that long-term trajectories of FBG may be important for risk prediction of MI and possibly other macrovascular diseases.",
author = "Cheng Jin and Shuohua Chen and Anand Vaidya and Yuntao Wu and Zhijun Wu and Hu, {Frank B.} and Penny Kris-Etherton and Shouling Wu and Xiang Gao",
year = "2017",
month = "11",
day = "1",
doi = "10.2337/dc17-0610",
language = "English (US)",
volume = "40",
pages = "1565--1572",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "11",

}

Longitudinal change in fasting blood glucose and myocardial infarction risk in a population without diabetes. / Jin, Cheng; Chen, Shuohua; Vaidya, Anand; Wu, Yuntao; Wu, Zhijun; Hu, Frank B.; Kris-Etherton, Penny; Wu, Shouling; Gao, Xiang.

In: Diabetes care, Vol. 40, No. 11, 01.11.2017, p. 1565-1572.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Longitudinal change in fasting blood glucose and myocardial infarction risk in a population without diabetes

AU - Jin, Cheng

AU - Chen, Shuohua

AU - Vaidya, Anand

AU - Wu, Yuntao

AU - Wu, Zhijun

AU - Hu, Frank B.

AU - Kris-Etherton, Penny

AU - Wu, Shouling

AU - Gao, Xiang

PY - 2017/11/1

Y1 - 2017/11/1

N2 - OBJECTIVE To examine the change in fasting blood glucose (FBG) during repeated assessments over time and its potential impact on the risk of developing myocardial infarction (MI). RESEARCH DESIGN AND METHODS This prospective cohort study included 68,297 participants without diabetes (mean age 49 years) whowere free ofMI, stroke, and cancer prior to or in 2010 (baseline of the current analysis). FBG concentrations were measured in 2006, 2008, and 2010. The FBG trajectories during 2006-2010, the primary exposure of the current study, were identified by latent mixture modeling. Incident MI cases were confirmed via review of medical records by cardiologists. RESULTS We identified five discrete FBG trajectories according to FBG range and changing pattern over time: elevated-stable (n = 3,877), elevated-decreasing (n = 7,060), moderate-increasing (n = 10,298), moderate-stable (n = 40,352), and low-stable (n = 6,710). During 4 years of follow-up, we documented 283 incident MI cases. Relative to the moderate-stable pattern (FBG ranged from 4.9 to 5.1 mmol/L), adjusted hazard ratios (HRs) were 1.53 (95% CI 1.04, 2.26) for the elevated-stable pattern (FBG ranged from 6.1 to 6.3 mmol/L) and HR 0.61 (95% CI 0.38, 0.98) for the elevated-decreasing pattern (FBG decreased from 6.0 to 5.4 mmol/L), after adjustment for potential confounders such as age, sex, lifestyle factors, obesity, medical history, blood pressure, blood lipids, and C-reactive protein. Consistently, cumulative average and increasing rate of FBG during 2006-2010, but not a single baseline FBG, predicted future risk of MI. CONCLUSIONS We found that discrete FBG trajectories were significantly associated with subsequent risk of MI in individuals without diabetes. These observations suggest that long-term trajectories of FBG may be important for risk prediction of MI and possibly other macrovascular diseases.

AB - OBJECTIVE To examine the change in fasting blood glucose (FBG) during repeated assessments over time and its potential impact on the risk of developing myocardial infarction (MI). RESEARCH DESIGN AND METHODS This prospective cohort study included 68,297 participants without diabetes (mean age 49 years) whowere free ofMI, stroke, and cancer prior to or in 2010 (baseline of the current analysis). FBG concentrations were measured in 2006, 2008, and 2010. The FBG trajectories during 2006-2010, the primary exposure of the current study, were identified by latent mixture modeling. Incident MI cases were confirmed via review of medical records by cardiologists. RESULTS We identified five discrete FBG trajectories according to FBG range and changing pattern over time: elevated-stable (n = 3,877), elevated-decreasing (n = 7,060), moderate-increasing (n = 10,298), moderate-stable (n = 40,352), and low-stable (n = 6,710). During 4 years of follow-up, we documented 283 incident MI cases. Relative to the moderate-stable pattern (FBG ranged from 4.9 to 5.1 mmol/L), adjusted hazard ratios (HRs) were 1.53 (95% CI 1.04, 2.26) for the elevated-stable pattern (FBG ranged from 6.1 to 6.3 mmol/L) and HR 0.61 (95% CI 0.38, 0.98) for the elevated-decreasing pattern (FBG decreased from 6.0 to 5.4 mmol/L), after adjustment for potential confounders such as age, sex, lifestyle factors, obesity, medical history, blood pressure, blood lipids, and C-reactive protein. Consistently, cumulative average and increasing rate of FBG during 2006-2010, but not a single baseline FBG, predicted future risk of MI. CONCLUSIONS We found that discrete FBG trajectories were significantly associated with subsequent risk of MI in individuals without diabetes. These observations suggest that long-term trajectories of FBG may be important for risk prediction of MI and possibly other macrovascular diseases.

UR - http://www.scopus.com/inward/record.url?scp=85033221601&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85033221601&partnerID=8YFLogxK

U2 - 10.2337/dc17-0610

DO - 10.2337/dc17-0610

M3 - Article

C2 - 28887409

AN - SCOPUS:85033221601

VL - 40

SP - 1565

EP - 1572

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 11

ER -