Glucose intolerance and 23-year risk of coronary heart disease and total mortality: the Honolulu Heart Program.
OBJECTIVE
The associations between glucose intolerance measured at the study entry date and the 23-year incidence of coronary heart disease (CHD), CHD mortality, and total mortality were examined at the Honolulu Heart Program.


METHODS
This prospective study followed a cohort of 8,006 Japanese-American men who were 45-68 years old and living on the island of Oahu, HI, in 1965. Baseline glucose was measured in a nonfasting state 1 h after a 50-g glucose load. History and use of medication for diabetes was obtained during an interview. The cohort was divided into four categories of glucose tolerance: low-normal, high-normal, asymptomatic hyperglycemia, and known diabetes.


RESULTS
During the 23 years of follow-up, 864 incident cases of CHD, 384 deaths from CHD, and 2,166 total deaths occurred. The relative risks (RRs) were obtained using Cox proportional hazards modeling, with the low-normal category as a reference. The RRs were adjusted for age only, as well as for age, BMI, hypertension, cholesterol, triglycerides, smoking, alcohol, and a Japanese diet index. The age-adjusted and risk factor-adjusted RRs for all outcomes were significant for the asymptomatic hyperglycemic and known diabetes groups (P<0.05). The age-adjusted RRs for CHD incidence and total mortality were marginally significant in the high-normal group, but the RRs were not significant when adjusted for risk factors.


CONCLUSIONS
These results suggest a dose-response relation of glucose intolerance at baseline with CHD incidence, CHD mortality, and total mortality, independent of other risk factors, in this cohort of middle-aged and older Japanese-American men.
Rodriguez
B L
BL
Department of Medicine, University of Hawaii at Manoa, USA. beatriz@hhp.hawaii-health.com
Lau
N
N
Burchfiel
C M
CM
Abbott
R D
RD
Sharp
D S
DS
Yano
K
K
Curb
J D
JD
D000368:Aged; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology / Q000401:mortality; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment