title: Metabolic Burden and Disease and Mortality Risk Associated with Impaired Fasting Glucose in Elderly Adults.
abstract: OBJECTIVE
  To examine whether impaired fasting glucose (IFG) represents an intermediary condition between normal fasting glucose and diabetes mellitus and, specifically, whether elderly adults with IFG have higher disease burden, cardiovascular risk, and systemic inflammation and higher 2-year mortality and incident disease.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Population-derived cohort.
  
  
  METHODS
  Individuals with a mean age of 78.6 ± 4.7 (N = 945).
  
  
  METHODS
  Disease was ascertained using a standardized questionnaire at baseline and 2 years. Fasting metabolic, inflammatory, and oxidative metabolism markers were measured. Disease prevalence, cardiovascular risk, and biochemical markers were compared to determine disease burden and metabolic disturbances in IFG. Adjusted odds ratios (ORs) for 2-year all-cause mortality and incident disease were determined.
  
  
  RESULTS
  IFG prevalence was 41%. Individuals with IFG had higher baseline rates of heart disease than those with normal fasting glucose (NFG), similar to that in individuals with diabetes mellitus. IFG was characterized by higher inflammatory markers and oxidative metabolism end products and was an intermediary between NFG and diabetes mellitus for triglycerides and malondialdehyde. Discriminant analysis showed that IFG was independently associated with stroke and higher triglycerides and oxidative stress. Two-year all-cause mortality was 3.9%. The 2-year adjusted ORs for all-cause mortality, incident cardiac disease, stroke, and cancer were similar between IFG and NFG, using both American Diabetes Association and World Health Organization IFG criteria. IFG did not predict secondary cardiac events, stroke, or cancer.
  
  
  CONCLUSIONS
  IFG was an intermediary condition for heart disease, inflammation, and oxidative stress in elderly adults but not for 2-year incident disease or all-cause mortality. Longer-term prospective studies are needed to clarify whether IFG in elderly adults portends greater morbidity and mortality.
authors.affiliation: Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.|Department of Endocrinology, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.
authors.forename: Katherine
authors.initials: K
authors.lastname: Samaras
authors.affiliation: Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Crawford
authors.affiliation: Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Lutgers
authors.affiliation: Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.|Department of Endocrinology, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.
authors.forename: Lesley V
authors.initials: LV
authors.lastname: Campbell
authors.affiliation: Department of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Bernhard T
authors.initials: BT
authors.lastname: Baune
authors.affiliation: South Eastern Area Laboratory Service, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Ora
authors.initials: O
authors.lastname: Lux
authors.affiliation: Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia.|Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.affiliation: Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia.|Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia.
authors.forename: Julian N
authors.initials: JN
authors.lastname: Trollor
authors.affiliation: Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia.|Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Perminder
authors.initials: P
authors.lastname: Sachdev
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D002423:Cause of Death; D005215:Fasting; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000209:etiology; D008297:Male; D018384:Oxidative Stress; D011236:Prediabetic State / Q000150:complications* / Q000401:mortality*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D001786:Blood Glucose
keywords: cancer; cardiovascular disease; cholesterol; diabetes mellitus; geriatric; glucose; hypertension; impaired fasting glucose; inflammation; obesity