title: Serum fructosamine and risk of type 2 diabetes mellitus among middle-age Finnish men: a 23-year population-based prospective study.
abstract: The aim of this study was to determine whether serum fructosamine is associated with the risk of type 2 diabetes mellitus (T2DM) in a cohort of middle-age Finnish men. Fructosamine and other cardiometabolic risk factors were measured in a sample of 2,520 subjects from the population-based Kuopio Ischemic Heart Disease study. Associations between baseline fructosamine levels and risk of T2DM involved Cox-regression analyses, progressively adjusted for potential confounders and mediators. Mean baseline age and fructosamine levels were 53 years and 267 µmol/L, respectively. During a median follow-up of 23 years (interquartile range 18-25 years), 153 (6.1 %) new cases of T2DM were recorded. We observed an approximately "J-shaped" association between fructosamine values and T2DM risk, with a nadir at about 250 µmol/L. In subjects with fructosamine ≥250 µmol/L, the hazard ratios per 1 standard deviation (28 µmol/L) higher fructosamine levels resulted 1.20 (95 % CI 1.00-1.44; p = 0.046) in a model adjusted for age, body mass index, systolic blood pressure, serum high-density lipoprotein-cholesterol and family history T2DM. This association did not materially change upon further adjustment for C-reactive protein, physical activity, serum triglyceride and insulin resistance. However, no association was found when adjusting for baseline fasting plasma glucose (FPG). In this cohort of middle-age Finnish men, we found a "J-shaped" relationship between fructosamine and risk of T2DM, with a higher risk in subjects with baseline levels of fructosamine ≥250 µmol/L. Such an increased risk, however, was not independent from baseline FPG levels.
authors.affiliation: Internal Medicine and Diabetes Care Unit, Catholic University, Rome, Italy, frazac@fastwebnet.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Zaccardi
authors.forename: Sudhir
authors.initials: S
authors.lastname: Kurl
authors.forename: Dario
authors.initials: D
authors.lastname: Pitocco
authors.forename: Kimmo
authors.initials: K
authors.lastname: Ronkainen
authors.forename: Jari A
authors.initials: JA
authors.lastname: Laukkanen
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology; D005387:Finland / Q000453:epidemiology; D019270:Fructosamine / Q000097:blood*; D006801:Humans; D008075:Lipoproteins, HDL / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D008075:Lipoproteins, HDL; D019270:Fructosamine; D002097:C-Reactive Protein