Associations of the Gap Between 2-Hour Post-Load Plasma Glucose and Fasting Blood Glucose With All-Cause or Cardiovascular Mortality in US Normoglycemic Adults.

Weiwei Liu, Zhiming Liu, Chen Ding, Jie Li, Haifeng Jiang
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Abstract

Background: The gap between 2-hour post-load plasma glucose (2 h PG) and fasting blood glucose (FBG) has been shown to be informative of the risk of developing prediabetes and diabetes. We aimed to examine the significance of the gap between 2 h PG and FBG in relation to all-cause or cardiovascular disease (CVD) mortality in normoglycemic adults.

Methods: 3611 normoglycemic participants from the 2005-2016 US National Health and Nutrition Examination Survey were included and dichotomized into the low (2 h PG ≤ FBG) and high post-load (2 h PG > FBG) groups. Associations of the gap between 2 h PG and FBG with all-cause or CVD mortality were evaluated with Kaplan-Meier curves, Cox proportional hazard ratio, and subgroup analysis.

Results: The mean age was 38.80 years, with a male prevalence of 43.59%. Finally, 1746 (50.22%) and 1865 (49.78%) participants were categorized into the low and high post-load groups, respectively. During a median follow-up of 107 months, 130 deaths (36 CVD-related) occurred. Kaplan-Meier curves showed significantly higher all-cause and CVD mortality rates in the high post-load group compared with the low post-load group. The hazard ratio and 95% confidence interval for all-cause and CVD mortality in the high post-load group were 1.816 (1.149-2.870) and 2.302 (1.052-5.038), respectively, with the low post-load group as the reference. The results were robust and consistent in the sensitivity and subgroup analyses.

Conclusion: The gap between 2 h PG and FBG may be potentially useful for predicting the risk of all-cause and CVD mortality in US normoglycemic adults.

在美国血糖正常的成年人中,负荷后2小时血糖和空腹血糖与全因死亡率或心血管死亡率之间的关系
背景:负荷后2小时血浆血糖(2h PG)和空腹血糖(FBG)之间的差距已被证明是发展为前驱糖尿病和糖尿病风险的信息。我们的目的是研究血糖正常的成年人2小时PG和FBG之间的差距与全因或心血管疾病(CVD)死亡率的关系。方法:从2005-2016年美国国家健康与营养调查中纳入3611名血糖正常的参与者,并将其分为低负荷组(2小时PG≤FBG)和高负荷组(2小时PG≤FBG)。通过Kaplan-Meier曲线、Cox比例风险比和亚组分析评估2 h PG和FBG之间的差距与全因或CVD死亡率的关系。结果:平均年龄38.80岁,男性患病率为43.59%。1746人(50.22%)和1865人(49.78%)分别被划分为低负荷组和高负荷组。在中位随访107个月期间,发生130例死亡(其中36例与心血管疾病相关)。Kaplan-Meier曲线显示,与低负荷组相比,高负荷组的全因死亡率和心血管疾病死亡率明显更高。以低负荷组为参照,高负荷组全因死亡率和CVD死亡率的风险比和95%可信区间分别为1.816(1.149 ~ 2.870)和2.302(1.052 ~ 5.038)。结果在敏感性和亚组分析中是稳健和一致的。结论:2小时PG和FBG之间的差距可能有助于预测美国正常血糖成人的全因和CVD死亡风险。
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