title: Subclinical states of glucose intolerance and risk of death in the U.S.
abstract: OBJECTIVE
  Although clinically evident type 2 diabetes is a well-established cause of mortality, less is known about subclinical states of glucose intolerance.
  
  
  METHODS
  Data from the Second National Health and Nutrition Examination Survey Mortality Study, a prospective study of adults, were analyzed. This analysis focused on a nationally representative sample of 3,174 adults aged 30-75 years who underwent an oral glucose tolerance test at baseline (1976-1980) and who were followed up for death through 1992.
  
  
  RESULTS
  Using 1985 World Health Organization criteria, adults were classified as having previously diagnosed diabetes (n = 248), undiagnosed diabetes (n = 183), impaired glucose tolerance (IGT) (n = 480), or normal glucose tolerance (n = 2,263). For these groups, cumulative all-cause mortality through age 70 was 41, 34, 27, and 20%, respectively (P < 0.001). Compared with those with normal glucose tolerance, the multivariate adjusted RR of all-cause mortality was greatest for adults with diagnosed diabetes (RR 2.11, 95% CI 1.56-2.84), followed by those with undiagnosed diabetes (1.77, 1.13-2.75) and those with IGT (1.42, 1.08-1.87; P < 0.001). A similar pattern of risk was observed for cardiovascular disease mortality.
  
  
  CONCLUSIONS
  In the U.S., there was a gradient of mortality associated with abnormal glucose tolerance ranging from a 40% greater risk in adults with IGT to a 110% greater risk in adults with clinically evident diabetes. These associations were independent of established cardiovascular disease risk factors.
authors: Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland, USA.
authors: S H
authors: SH
authors: Saydah
authors: C M
authors: CM
authors: Loria
authors: M S
authors: MS
authors: Eberhardt
authors: F L
authors: FL
authors: Brancati
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology* / Q000401:mortality; D005951:Glucose Tolerance Test; D006306:Health Surveys; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012307:Risk Factors; D012907:Smoking; D014481:United States / Q000453:epidemiology; D014944:World Health Organization
chemical_list: D008055:Lipids