Two-hour glucose is a better risk predictor for incident coronary heart disease and cardiovascular mortality than fasting glucose.
OBJECTIVE
To assess the predictive value of fasting and 2-h glucose after a 75 g glucose load, with regard to incidence of coronary heart disease and cardiovascular mortality.


RESULTS
6766 subjects from five Finnish cohorts aged 30-89 years were followed up for 7-10 years. Hazards ratios associated with increasing glucose concentrations were homogeneous over studies. Multivariate Cox regression analyses showed that the hazards ratio for one standard deviation increase in 2-h glucose after logarithmic transformation was 1.17 (95% CI 1.05-1.30) for coronary heart disease incidence and 1.22 (1.09-1.37) for cardiovascular mortality. For fasting glucose, they were 1.05 (0.94-1.17) and 1.13 (1.01-1.25), respectively. Inclusion of 2-h glucose in the model based on fasting glucose significantly improved the prediction (P<0.005 for coronary heart disease incidence and P<0.025 for cardiovascular mortality), whereas fasting glucose did not add significant information to the model initially based on 2-h glucose (P>0.10 for both events).


CONCLUSIONS
In subjects without a prior history of diabetes the association of 2-h glucose with coronary heart disease incidence and cardiovascular morality is graded and independent. The results of our study indicate that 2-h glucose is superior to fasting glucose in assessing the risk of future cardiovascular disease events.
Qiao
Q
Q
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
Pyörälä
K
K
Pyörälä
M
M
Nissinen
A
A
Lindström
J
J
Tilvis
R
R
Tuomilehto
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D005215:Fasting / Q000097:blood*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000150:complications* / Q000175:diagnosis*; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment; D015996:Survival Rate; D013997:Time Factors
D001786:Blood Glucose