Two hour plasma glucose is not unequivocally predictive for early death in men with impaired fasting glucose: more results from the Paris Prospective Study.
OBJECTIVE
We examined whether the 2-h plasma glucose (2 hPG) concentration after a 75 g OGTT is predictive of death in men with a diabetic, an impaired or a normal fasting plasma glucose concentration (DM-FPG: > or =7.0 mmol/l; IFG: 6.1-6.9 mmol/l; normal-FPG: <6.1 mmol/l).


METHODS
The 17-year mortality of 7018 men, aged 44 to 55 years, from the Paris Prospective Study, who were not known to be diabetic at baseline was studied.


RESULTS
The 2 hPG was not associated with early mortality in men with a DM-FPG in contrast to men with an IFG or a normal-FPG; for an increase from 10 to 11 mmol/l in the 2 hPG, the age-adjusted hazards ratios were 1.01 (95% CI 0.95-1.08), 1.15 (1.03-1.28) and 1.24 (1.18-1.31) respectively. Coronary heart disease mortality and within this category sudden death but not ischaemic heart disease death, were related with 2 hPG but only in the men with normal FPG. However, the prediction by 2 hPG did not differ between the men with DM-FPG, an IFG or a normal-FPG: the overall age-adjusted hazards ratios for these three causes of death were 1.09 (1.00-1.18), 1.13 (1.02-1.26) and 1.13 (0.99-1.29), respectively.


CONCLUSIONS
2 hPG is unequivocally prognostic for all-cause mortality only in men with normal FPG. Screening men with an IFG by using a 75 g OGTT is of limited benefit.
Balkau
B
B
INSERM U258-IFR69 and Faculty of Medicine University Paris XI, Villejuif, France. balkau@vjf.inserm.fr
Forhan
A
A
Eschwège
E
E
D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000401:mortality; D018149:Glucose Intolerance / Q000097:blood* / Q000401:mortality; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D010297:Paris; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012016:Reference Values; D012907:Smoking; D015996:Survival Rate; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin; D002784:Cholesterol