Impact of glucose tolerance status on development of ischemic stroke and coronary heart disease in a general Japanese population: the Hisayama study.
OBJECTIVE
Few studies have shown the association between glucose tolerance status defined by a 75-g oral glucose tolerance test and the development of different types of cardiovascular disease.


METHODS
A total of 2421 community-dwelling Japanese subjects aged 40 to 79 years who underwent the oral glucose tolerance test were followed up for 14 years.


RESULTS
In multivariable analysis, the risks of ischemic stroke in both sexes and coronary heart disease (CHD) in women were significantly higher in subjects with diabetes determined by the World Health Organization criteria than in those with normal glucose tolerance even after adjustment for other confounding factors, but such association was not seen for CHD in men (ischemic stroke: adjusted hazard ratio [HR]=2.54, P=0.002 in men; adjusted HR=2.02, P=0.03 in women; CHD: adjusted HR=1.26, P=0.47 in men; adjusted HR=3.46, P=0.002 in women). Similar associations were observed for fasting plasma glucose levels of >or=7.0 mmol/L (ischemic stroke: adjusted HR=2.15, P=0.03 in men; adjusted HR=2.10, P=0.045 in women; CHD: adjusted HR=1.29, P=0.47 in men; adjusted HR=3.83, P=0.003 in women) and for 2-hour postload glucose levels of >or=11.1 mmol/L (ischemic stroke: adjusted HR=2.71, P=0.003 in men; adjusted HR=2.19, P=0.03 in women; CHD: adjusted HR=1.58, P=0.16 in men; adjusted HR=4.44, P<0.001 in women). The age-adjusted incidences of ischemic stroke and CHD did not significantly increase in subjects with impaired fasting glycemia or impaired glucose tolerance in either sex.


CONCLUSIONS
Our findings suggest that diabetes is an independent risk factor for ischemic stroke in both sexes and CHD in women in the Japanese population.
Doi
Yasufumi
Y
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan. doi@intmed2.med.kyushu-u.ac.jp
Ninomiya
Toshiharu
T
Hata
Jun
J
Fukuhara
Masayo
M
Yonemoto
Koji
K
Iwase
Masanori
M
Iida
Mitsuo
M
Kiyohara
Yutaka
Y
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001786:Blood Glucose / Q000502:physiology; D002545:Brain Ischemia / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test / Q000706:statistics & numerical data*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology
D001786:Blood Glucose