Prospective study of fasting blood glucose and intracerebral hemorrhagic risk

Cheng Jin, Guohong Li, Kathryn M. Rexrode, Mahmut E. Gurol, Xiaodong Yuan, Ying Hui, Chunyu Ruan, Anand Vaidya, Yanxiu Wang, Shouling Wu, Xiang Gao

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background and Purpose—Although diabetes mellitus is an established independent risk factor for ischemic stroke, the association between fasting blood glucose and intracerebral hemorrhage (ICH) is limited and inconsistent. The objective of the current study was to examine the potential impact of long-term fasting blood glucose concentration on subsequent risk of ICH. Methods—This prospective study included 96 110 participants of the Kailuan study, living in Kailuan community, Tangshan city, China, who were free of cardiovascular diseases and cancer at baseline (2006). Fasting blood glucose concentration was measured in 2006, 2008, 2010, and 2012. Updated cumulative average fasting blood glucose concentration was used as primary exposure of the current study. Incident ICH from 2006 to 2015 was confirmed by review of medical records. Results—During 817 531 person-years of follow-up, we identified 755 incident ICH cases. The nadir risk of ICH was observed at fasting blood glucose concentration of 5.3 mmol/L. The adjusted hazard ratios and their 95% confidence intervals (CIs) of ICH were 1.59 (95% CI, 1.26–2.02) for diabetes mellitus or fasting blood glucose ≥7.00 mmol/L, 1.31 (95% CI, 1.02–1.69) for impaired fasting blood glucose (fasting blood glucose, 6.10–6.99 mmol/L), 0.98 (95% CI, 0.78–1.22) for fasting blood glucose 5.60 to 6.09 mmol/L, and 2.04 (95% CI, 1.23–3.38) for hypoglycemia (fasting blood glucose, <4.00 mmol/L), comparing with normal fasting blood glucose 4.00 to 5.59 mmol/L. The results persisted after excluding individuals who used hypoglycemic, aspirin, antihypertensive agents, or anticoagulants, and those with intracerebral hemorrhagic cases occurred in the first 2 years of follow-up. Conclusions—In this large community-based cohort, low (<4.0 mmol/L) and high (≥6.1 mmol/L) fasting blood glucose concentrations were associated with higher risk of incident ICH, relative to fasting blood glucose concentrations of 4.00 to 6.09 mmol/L.

Original languageEnglish (US)
Pages (from-to)27-33
Number of pages7
JournalStroke
Volume49
Issue number1
DOIs
StatePublished - Jan 1 2018

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Blood Glucose
Fasting
Prospective Studies
Cerebral Hemorrhage
Confidence Intervals
Diabetes Mellitus
Hypoglycemia
Hypoglycemic Agents
Anticoagulants
Antihypertensive Agents
Aspirin
Medical Records
China
Cardiovascular Diseases
Stroke

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Jin, Cheng ; Li, Guohong ; Rexrode, Kathryn M. ; Gurol, Mahmut E. ; Yuan, Xiaodong ; Hui, Ying ; Ruan, Chunyu ; Vaidya, Anand ; Wang, Yanxiu ; Wu, Shouling ; Gao, Xiang. / Prospective study of fasting blood glucose and intracerebral hemorrhagic risk. In: Stroke. 2018 ; Vol. 49, No. 1. pp. 27-33.
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title = "Prospective study of fasting blood glucose and intracerebral hemorrhagic risk",
abstract = "Background and Purpose—Although diabetes mellitus is an established independent risk factor for ischemic stroke, the association between fasting blood glucose and intracerebral hemorrhage (ICH) is limited and inconsistent. The objective of the current study was to examine the potential impact of long-term fasting blood glucose concentration on subsequent risk of ICH. Methods—This prospective study included 96 110 participants of the Kailuan study, living in Kailuan community, Tangshan city, China, who were free of cardiovascular diseases and cancer at baseline (2006). Fasting blood glucose concentration was measured in 2006, 2008, 2010, and 2012. Updated cumulative average fasting blood glucose concentration was used as primary exposure of the current study. Incident ICH from 2006 to 2015 was confirmed by review of medical records. Results—During 817 531 person-years of follow-up, we identified 755 incident ICH cases. The nadir risk of ICH was observed at fasting blood glucose concentration of 5.3 mmol/L. The adjusted hazard ratios and their 95{\%} confidence intervals (CIs) of ICH were 1.59 (95{\%} CI, 1.26–2.02) for diabetes mellitus or fasting blood glucose ≥7.00 mmol/L, 1.31 (95{\%} CI, 1.02–1.69) for impaired fasting blood glucose (fasting blood glucose, 6.10–6.99 mmol/L), 0.98 (95{\%} CI, 0.78–1.22) for fasting blood glucose 5.60 to 6.09 mmol/L, and 2.04 (95{\%} CI, 1.23–3.38) for hypoglycemia (fasting blood glucose, <4.00 mmol/L), comparing with normal fasting blood glucose 4.00 to 5.59 mmol/L. The results persisted after excluding individuals who used hypoglycemic, aspirin, antihypertensive agents, or anticoagulants, and those with intracerebral hemorrhagic cases occurred in the first 2 years of follow-up. Conclusions—In this large community-based cohort, low (<4.0 mmol/L) and high (≥6.1 mmol/L) fasting blood glucose concentrations were associated with higher risk of incident ICH, relative to fasting blood glucose concentrations of 4.00 to 6.09 mmol/L.",
author = "Cheng Jin and Guohong Li and Rexrode, {Kathryn M.} and Gurol, {Mahmut E.} and Xiaodong Yuan and Ying Hui and Chunyu Ruan and Anand Vaidya and Yanxiu Wang and Shouling Wu and Xiang Gao",
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Jin, C, Li, G, Rexrode, KM, Gurol, ME, Yuan, X, Hui, Y, Ruan, C, Vaidya, A, Wang, Y, Wu, S & Gao, X 2018, 'Prospective study of fasting blood glucose and intracerebral hemorrhagic risk', Stroke, vol. 49, no. 1, pp. 27-33. https://doi.org/10.1161/STROKEAHA.117.019189

Prospective study of fasting blood glucose and intracerebral hemorrhagic risk. / Jin, Cheng; Li, Guohong; Rexrode, Kathryn M.; Gurol, Mahmut E.; Yuan, Xiaodong; Hui, Ying; Ruan, Chunyu; Vaidya, Anand; Wang, Yanxiu; Wu, Shouling; Gao, Xiang.

In: Stroke, Vol. 49, No. 1, 01.01.2018, p. 27-33.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prospective study of fasting blood glucose and intracerebral hemorrhagic risk

AU - Jin, Cheng

AU - Li, Guohong

AU - Rexrode, Kathryn M.

AU - Gurol, Mahmut E.

AU - Yuan, Xiaodong

AU - Hui, Ying

AU - Ruan, Chunyu

AU - Vaidya, Anand

AU - Wang, Yanxiu

AU - Wu, Shouling

AU - Gao, Xiang

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background and Purpose—Although diabetes mellitus is an established independent risk factor for ischemic stroke, the association between fasting blood glucose and intracerebral hemorrhage (ICH) is limited and inconsistent. The objective of the current study was to examine the potential impact of long-term fasting blood glucose concentration on subsequent risk of ICH. Methods—This prospective study included 96 110 participants of the Kailuan study, living in Kailuan community, Tangshan city, China, who were free of cardiovascular diseases and cancer at baseline (2006). Fasting blood glucose concentration was measured in 2006, 2008, 2010, and 2012. Updated cumulative average fasting blood glucose concentration was used as primary exposure of the current study. Incident ICH from 2006 to 2015 was confirmed by review of medical records. Results—During 817 531 person-years of follow-up, we identified 755 incident ICH cases. The nadir risk of ICH was observed at fasting blood glucose concentration of 5.3 mmol/L. The adjusted hazard ratios and their 95% confidence intervals (CIs) of ICH were 1.59 (95% CI, 1.26–2.02) for diabetes mellitus or fasting blood glucose ≥7.00 mmol/L, 1.31 (95% CI, 1.02–1.69) for impaired fasting blood glucose (fasting blood glucose, 6.10–6.99 mmol/L), 0.98 (95% CI, 0.78–1.22) for fasting blood glucose 5.60 to 6.09 mmol/L, and 2.04 (95% CI, 1.23–3.38) for hypoglycemia (fasting blood glucose, <4.00 mmol/L), comparing with normal fasting blood glucose 4.00 to 5.59 mmol/L. The results persisted after excluding individuals who used hypoglycemic, aspirin, antihypertensive agents, or anticoagulants, and those with intracerebral hemorrhagic cases occurred in the first 2 years of follow-up. Conclusions—In this large community-based cohort, low (<4.0 mmol/L) and high (≥6.1 mmol/L) fasting blood glucose concentrations were associated with higher risk of incident ICH, relative to fasting blood glucose concentrations of 4.00 to 6.09 mmol/L.

AB - Background and Purpose—Although diabetes mellitus is an established independent risk factor for ischemic stroke, the association between fasting blood glucose and intracerebral hemorrhage (ICH) is limited and inconsistent. The objective of the current study was to examine the potential impact of long-term fasting blood glucose concentration on subsequent risk of ICH. Methods—This prospective study included 96 110 participants of the Kailuan study, living in Kailuan community, Tangshan city, China, who were free of cardiovascular diseases and cancer at baseline (2006). Fasting blood glucose concentration was measured in 2006, 2008, 2010, and 2012. Updated cumulative average fasting blood glucose concentration was used as primary exposure of the current study. Incident ICH from 2006 to 2015 was confirmed by review of medical records. Results—During 817 531 person-years of follow-up, we identified 755 incident ICH cases. The nadir risk of ICH was observed at fasting blood glucose concentration of 5.3 mmol/L. The adjusted hazard ratios and their 95% confidence intervals (CIs) of ICH were 1.59 (95% CI, 1.26–2.02) for diabetes mellitus or fasting blood glucose ≥7.00 mmol/L, 1.31 (95% CI, 1.02–1.69) for impaired fasting blood glucose (fasting blood glucose, 6.10–6.99 mmol/L), 0.98 (95% CI, 0.78–1.22) for fasting blood glucose 5.60 to 6.09 mmol/L, and 2.04 (95% CI, 1.23–3.38) for hypoglycemia (fasting blood glucose, <4.00 mmol/L), comparing with normal fasting blood glucose 4.00 to 5.59 mmol/L. The results persisted after excluding individuals who used hypoglycemic, aspirin, antihypertensive agents, or anticoagulants, and those with intracerebral hemorrhagic cases occurred in the first 2 years of follow-up. Conclusions—In this large community-based cohort, low (<4.0 mmol/L) and high (≥6.1 mmol/L) fasting blood glucose concentrations were associated with higher risk of incident ICH, relative to fasting blood glucose concentrations of 4.00 to 6.09 mmol/L.

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