title: Fasting plasma glucose in non-diabetic participants and the risk for incident cardiovascular events, diabetes, and mortality: results from WOSCOPS 15-year follow-up.
abstract: OBJECTIVE
  The evidence base for fasting plasma glucose (FPG) in the non-diabetic range as a risk factor for cardiovascular disease (CVD) is inconclusive. We investigated this question in the West of Scotland Coronary Prevention Study (WOSCOPS).
  
  
  RESULTS
  In WOSCOPS, we related FPG in 6447 men (mean age 55 years) with hypercholesterolaemia, but no history of CVD or diabetes, to the risk of cardiovascular events and mortality over 14.7 years of follow-up; 2381 non-fatal/fatal cardiovascular events and 1244 deaths occurred. Participants were divided into fifths of baseline FPG, Q1 (< or =4.3 mmol/L) to Q5 (>5.1-6.9 mmol/L). Q2 was designated the referent based on previous studies which have suggested a J-shaped relationship between FPG and CVD. Compared with Q2 (>4.3-4.6 mmol/L), men in Q5 had no elevated risk for cardiovascular events [hazard ratio (HR) 0.95 (0.83-1.08)], or all-cause mortality [HR 0.96 (0.80-1.15)] in fully adjusted analyses despite a significant risk for incident diabetes [HR 22.05 (10.75-45.22)]. After further dividing Q5 into fifths, Q5a-e, individuals in Q5e (FPG 5.8-6.9 mmol/L) were also not at increased risk of cardiovascular events [HR 1.05 (0.82-1.35)] or other endpoints compared with Q2. All results were similar using Q1 as the referent.
  
  
  CONCLUSIONS
  Elevations in FPG in the non-diabetic range were not associated with long-term risk of cardiovascular events in middle-aged men in WOSCOPS. These data suggest that the current FPG cutoff for diagnosing diabetes also appropriately identifies western men at risk of CVD.
authors.affiliation: Faculty of Medicine, University of Glasgow, Glasgow, UK. d.preiss@clinmed.gla.ac.uk
authors.forename: David
authors.initials: D
authors.lastname: Preiss
authors.forename: Paul
authors.initials: P
authors.lastname: Welsh
authors.forename: Heather M
authors.initials: HM
authors.lastname: Murray
authors.forename: James
authors.initials: J
authors.lastname: Shepherd
authors.forename: Chris
authors.initials: C
authors.lastname: Packard
authors.forename: Peter
authors.initials: P
authors.lastname: Macfarlane
authors.forename: Stuart
authors.initials: S
authors.lastname: Cobbe
authors.forename: Ian
authors.initials: I
authors.lastname: Ford
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003327:Coronary Disease / Q000401:mortality; D003925:Diabetic Angiopathies / Q000097:blood / Q000401:mortality*; D005215:Fasting / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology
chemical_list: D001786:Blood Glucose
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