title: Fasting glucose level and the risk of incident atherosclerotic cardiovascular diseases.
abstract: OBJECTIVE
  Although diabetes increases the risk of cardiovascular disease (CVD) and mortality, the dose-response relationship between fasting glucose levels below those diagnostic of diabetes with cardiovascular events has not been well characterized.
  
  
  METHODS
  A prospective cohort study of more than one million Koreans was conducted with a mean follow-up of 16 years. A total of 1,197,384 Korean adults with no specific medical conditions diagnosed were classified by baseline fasting serum glucose level. Associations of fasting glucose level with CVD incidence and mortality, stroke incidence and mortality, and all-cause mortality were analyzed using multivariate proportional hazards regression.
  
  
  RESULTS
  The relationships between fasting glucose levels and CVD risks generally followed J-shape curves, with lowest risk in the glucose range of 85-99 mg/dL. As fasting glucose levels increased to >100 mg/dL, risks for CVD, ischemic heart disease, myocardial infarction, and thrombotic stroke progressively increased, but risk for hemorrhagic stroke did not. Fasting glucose levels <70 mg/dL were associated with increased risk of all stroke (hazard ratio 1.06, 95% CI 1.01-1.11) in men and (hazard ratio 1.11, 1.05-1.17) in women.
  
  
  CONCLUSIONS
  Both low glucose level and impaired fasting glucose should be considered as predictors of risk for stroke and coronary heart disease. The fasting glucose level associated with the lowest cardiovascular risk may be in a narrow range.
authors: International Health Care Center, Severance Hospital, Seoul, Korea.
authors: Chanshin
authors: C
authors: Park
authors: Eliseo
authors: E
authors: Guallar
authors: John A
authors: JA
authors: Linton
authors: Duk-Chul
authors: DC
authors: Lee
authors: Yangsoo
authors: Y
authors: Jang
authors: Dong Koog
authors: DK
authors: Son
authors: Eun-Jeong
authors: EJ
authors: Han
authors: Soo Jin
authors: SJ
authors: Baek
authors: Young Duk
authors: YD
authors: Yun
authors: Sun Ha
authors: SH
authors: Jee
authors: Jonathan M
authors: JM
authors: Samet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology*; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology
chemical_list: D001786:Blood Glucose
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