title: Hyperglycemia and incidence of ischemic and hemorrhagic stroke-comparison between fasting and 2-hour glucose criteria.
abstract: OBJECTIVE
  We examined the impact of hyperglycemia on ischemic and hemorrhagic stroke incidence comparing criteria based on fasting plasma glucose (FPG) and 2-hour plasma glucose (2-hour PG).
  
  
  METHODS
  Data from 9 European cohorts comprising 18 360 individuals between 25 to 90 years of age were collaboratively analyzed. The maximum length of follow-up varied between 4.9 to 36.8 years. Hazards ratios (95% confidence intervals) for stroke incidence were estimated using Cox-proportional hazards model adjusting for known risk factors.
  
  
  RESULTS
  In individuals without a prior history of diabetes, the multivariate-adjusted hazards ratio for ischemic stroke corresponding to 1 SD increase in FPG was 1.12 (1.02 to 1.22) and in 2-hour PG 1.14 (1.05 to 1.24). Adding 2-hour PG to the model with FPG significantly improved the prediction of the model for the incidence of ischemic stroke (chi(2)=4.72, P=0.03), whereas FPG did not improve the 2-hour PG model prediction (chi(2)=0.25, P=0.62). A significantly increased hazard ratio was also observed for previously diagnosed diabetes (2.26 [1.51 to 3.38]) and for screen-detected diabetes defined by FPG (1.48 [1.08 to 2.02]) and 2-hour PG (1.60 [1.18 to 2.16]). None of the criteria predicted hemorrhagic stroke.
  
  
  CONCLUSIONS
  Diabetes defined by either of the criteria predicted the future risk of ischemic stroke but not the hemorrhagic stroke. The prediction is stronger for elevated 2-hour PG than for FPG levels.
authors.affiliation: Department of Public Health, University of Helsinki, PL 41, Mannerheimintie 172, Helsinki, Finland. marjukka.hyvarinen@helsinki.fi
authors.forename: Marjukka
authors.initials: M
authors.lastname: Hyvärinen
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: Markku
authors.initials: M
authors.lastname: Mähönen
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Kalevi
authors.initials: K
authors.lastname: Pyörälä
authors.forename: Björn
authors.initials: B
authors.lastname: Zethelius
authors.forename: Qing
authors.initials: Q
authors.lastname: Qiao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000453:epidemiology*; D003627:Data Interpretation, Statistical; D048909:Diabetes Complications / Q000453:epidemiology; D005215:Fasting / Q000097:blood*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D020521:Stroke / Q000097:blood / Q000453:epidemiology* / Q000209:etiology*; D013548:Sweden / Q000453:epidemiology
chemical_list: D001786:Blood Glucose