Fasting and postchallenge hyperglycemia and risk of cardiovascular disease in Chinese: the Chin-Shan Community Cardiovascular Cohort study.
BACKGROUND
Whether fasting glucose is superior to postchallenge glucose or insulin level for prediction of cardiovascular disease (CVD) remains controversial. The aim of our study was to compare fasting, postchallenge glucose and other markers as predictors of CVD in a community-based prospective cohort study among 2,165 adult participants.


METHODS
A standard 75-g oral glucose tolerance test was performed, with measurements of fasting and 2-hour postchallenge plasma glucose and insulin levels. We defined the CVD outcome as incident coronary heart disease and stroke. Cox regression model was used to estimate the relative risk (RR) for CVD.


RESULTS
A total of 166 individuals developed major CVD events during 10.5 years of follow-up. Both fasting and postchallenge glucose were significantly associated with CVD risk (adjusted RR in the highest quartile vs the lowest quartile 1.74, 95% confidence interval [CI] 1.06-2.86 for fasting glucose; RR in highest quartile 2.05, 95% CI 1.23-3.42 for postchallenge glucose). Postchallenge and fasting glucose had similar areas of receiver operative characteristics curves (0.65, 95% CI 0.58-0.72 for postchallenge glucose; 0.65, 95% CI 0.58-0.72 for fasting glucose). In mutually adjusted models, fasting and postchallenge glucose remained significant risk factors for CVD, whereas insulin resistance variables became nonsigificant.


CONCLUSIONS
These findings show that fasting and postchallenge glucose concentrations are independent predictors of CVD risk among ethnic Chinese in Taiwan.
Chien
Kuo-Liong
KL
Department of Nutrition, School of Public Health, Harvard University, Boston, MA 02115, USA.
Hsu
Hsiu-Ching
HC
Su
Ta-Chen
TC
Chen
Ming-Fong
MF
Lee
Yuan-Teh
YT
Hu
Frank B
FB
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D002681:China / Q000208:ethnology; D005215:Fasting; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
D001786:Blood Glucose