Postchallenge Hyperglycemia and Mortality in a National Sample of U.S. Adults
Abstract
OBJECTIVE—Although postchallenge hyperglycemia is a well-established feature of type 2 diabetes, its association with risk of mortality is uncertain. Therefore, the aim of this study was to assess the independent association of fasting and 2-h glucose levels with all-cause and cardiovascular disease (CVD) mortality. RESEARCH DESIGN AND METHODS—We analyzed data from the Second National Health and Nutrition Examination Survey (NHANES II) Mortality Study, a prospective cohort study of U.S. adults examined in the NHANES II, and focused on the 3,092 adults aged 30–74 years who underwent an oral glucose tolerance test at baseline (1976–1980). Deaths were identified from U.S. national mortality files from 1976 to 1992. To account for the complex survey design, we used SUDAAN statistical software for weighted analysis. RESULTS—Compared with their normoglycemic counterparts (fasting glucose [FG] <7.0 and 2-h glucose <7.8 mmol/l), adults with fasting and postchallenge hyperglycemia (FG ≥7.0 and 2-h glucose ≥11.1 mmol/l) had a twofold higher risk of death after 16 years of follow-up (age- and sex-adjusted relative hazard [RH] 2.1, 95% CI 1.4–3.2). However, adults with isolated postchallenge hyperglycemia (FG <7.0 and 2-h glucose ≥11.1 mmol/l) were also at higher risk of death (1.6, 1.0–2.6). In proportional hazards analysis, FG (fully adjusted RH 1.10 per 1 SD; 95% CI 1.01, 1.22) and 2-h glucose (1.14, 1.00–1.29) showed nearly identical predictive value for mortality. Similar trends were observed for CVD mortality. CONCLUSIONS—These results suggest that postchallenge hyperglycemia is associated with increased risk of all-cause and CVD mortality independently of other CVD risk factors.
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After adjusting for age and sex, increased risk of cardiovascular disease mortality was observed in those with postchallenge hyperglycemia and fasting glucose at least 7.0 mmol/l, with 2-hour glucose at least 7.8 and below 11.1 mmol/l and fasting glucose below 7.0 mmol/l, or with postchallenge hyperglycemia and fasting glucose below 7.0 mmol/l.
“After adjusting for age and sex, an increased risk of CVD mortality was observed in those with postchallenge hyperglycemia (PCH) and fasting glucose ≥7.0 mmol/l, with 2-h glucose ≥7.8 and <11.1 mmol/l and fasting glucose <7.0 mmol/l, or with PCH and fasting glucose <7.0 mmol/l (459).”
From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [459]
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References 33 · Cited by 221
- Authors
- Saydah, S. H., Miret, M., Sung, J., Varas, C., Gause, D., & Brancati, F. L.
- Affiliations
- Johns Hopkins University (US)
- Novartis (Spain) (ES)
- Health Care Management, Novartis Pharmaceuticals, East Hanover, New Jersey
- Global Epidemiology, CS&-E, Novartis Farmacéutica, Barcelona, Spain
- ORCID
- Saydah, Sharon H.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2001-08-01
- Volume
- 24
- Issue
- 8
- Pages
- 1397-1402
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2039665861
- Cited by
- 221
- References
- 33
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 6 · 2022: 5 · 2021: 3 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 8 · 2016: 14 · 2015: 11 · 2014: 7 · 2013: 11 · 2012: 15
- FWCI
- 7.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- fasting blood glucose, 2-hour plasma glucose, oral glucose tolerance test, all-cause mortality, cardiovascular mortality, type 2 diabetes, cardiovascular risk factors
- MeSH terms
- Adult, Aged, Blood Glucose, Blood Pressure, Coronary Disease, Diabetes Mellitus, Educational Status, Ethnicity, Female, Glucose Tolerance Test, Humans, Hyperglycemia, Male, Middle Aged, Prospective Studies, Reference Values, Smoking, United States, Cohort Studies, Body Mass Index, Glucose Intolerance
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