Low fasting plasma glucose level as a predictor of cardiovascular disease and all-cause mortality
Open accessAbstract
BACKGROUND: Although medical textbooks usually classify fasting plasma glucose <70 or 80 mg/dL (<3.89 or 4.44 mmol/L) as abnormal, the prognosis for patients with low fasting plasma glucose is unclear. METHODS AND RESULTS: We conducted prospective cohort studies among 40 069 men and women to investigate the association between fasting plasma glucose levels and cardiovascular disease and all-cause mortality. We documented a U-shaped relation between fasting plasma glucose and mortality. In addition to diabetes and impaired fasting glucose levels, low fasting plasma glucose levels were also associated with high mortality. After multivariate adjustment for age, sex, study population, ethnicity, current smoking status, high blood pressure, total cholesterol, body mass index, triglycerides, history of cardiovascular disease and cancer, and a family history of cardiovascular disease, patients with fasting plasma glucose <70 mg/dL (<3.89 mmol/L) had a 3.3-fold increased risk of cardiovascular disease mortality, and patients with fasting plasma glucose 70 to 79 mg/dL (3.89 to 4.43 mmol/L) had a 2.4-fold increased risk compared with the risk in patients with fasting plasma glucose 80 to 109 mg/dL (4.44 to 6.05 mmol/L) (tests for trend P<0.0001). Participants with low fasting plasma glucose levels also had increased risk of all-cause mortality (test for trend P<0.0001). CONCLUSIONS: Participants with low fasting plasma glucose levels had a high risk of cardiovascular disease and all-cause mortality.
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Hypoglycemia induces vascular effects such as the activation of prothrombotic, proinflammatory, and proatherogenic components resulting in an increased risk for cardiovascular diseases.
“Hypoglycemia induces vascular effects such as the activation of prothrombotic, proinflammatory, and proatherogenic components resulting in an increased risk for cardiovascular diseases [ 46 , 47 ].”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [47]
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- Authors
- Wei, M., Gibbons, L. W., Mitchell, T. L., Kampert, J. B., Stern, M. P., & Blair, S. N.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- From the Cooper Institute (M.W., J.B.K., S.N.B.) and the Cooper Clinic (L.W.G., T.L.M.), Dallas, and the Department of Medicine (M.P.S.), University of Texas Health Science Center, San Antonio, Tex.
- ORCID
- Blair, Steven N.
- Venue
- Circulation
- Published
- 2000-05-02
- Volume
- 101
- Issue
- 17
- Pages
- 2047-2052
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1982312599
- Cited by
- 142
- References
- 24
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 8 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 16 · 2019: 11 · 2018: 5 · 2017: 7 · 2016: 6 · 2015: 3 · 2014: 4 · 2013: 8 · 2012: 8
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Scholar Commons (University of South Carolina) (submittedVersion)
- Funders
- National Institutes of Health (5r37hl036820-10)
- National Institute on Aging (AG06945)
- National Heart, Lung, and Blood Institute (R37HL36820, R01HL024799, R01HL24799)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- hypoglycemia, cardiovascular mortality, all-cause mortality, U-shaped relationship, impaired fasting glucose, diabetes mellitus, prognosis
- MeSH terms
- Adult, Aged, Aged, 80 and over, Blood Glucose, Cardiovascular Diseases, Fasting, Female, Humans, Male, Middle Aged, Mortality, Prospective Studies, Risk Factors, Survival Analysis
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