title: Normal fasting plasma glucose predicts type 2 diabetes and cardiovascular disease in elderly population in Taiwan.
abstract: BACKGROUND
  Hyperglycemia increases prevalence of metabolic syndrome (MetS), type 2 diabetes (T2D) and cardiovascular disease (CVD). But the role of normoglycemia on the development of T2D and CVD in elderly population remains unclear.
  
  
  OBJECTIVE
  To determine an optimal cut-off for fasting plasma glucose (FPG) to predict MetS and subsequent risk of T2D and CVD in an elderly Taiwanese population with normal FPG levels.
  
  
  METHODS
  Two stages included cross-sectional (Stage 1) and prospective (Stage 2) cohort study.
  
  
  METHODS
  In Stage 1 18 287 subjects aged  ≥60 years were enrolled; of these, 5039 without T2D and CVD advanced to Stage 2 and a mean follow-up of 3.8 years. MetS components were analysed, and in Stage 1, FPG cut-offs for MetS risk were calculated using receiver operating characteristic (ROC) curve analyses. In Stage 2, subjects without T2D and CVD in Stage 1 were classified into high-FPG and low-FPG groups based on cut-offs, and sex specific differences in incidence for T2D and CVD were calculated.
  
  
  RESULTS
  ROC curve analysis gave an optimal FPG cut-off for MetS of 93 mg/dl and 92 mg/dl for males and females, respectively. The high-FPG group had a 1.599- and 1.353-fold higher chance of developing T2D compared with the low-FPG group for males and females, respectively (95% CI: 1.606-2.721 and 1.000-1.831, P  =  0.015 and 0.05). The high-FPG group had a 1.24-fold higher chance of developing CVD for females (95% CI: 1.015-1.515, P  =  0.035); however, there was no difference for males.
  
  
  CONCLUSIONS
  Our results suggest that FPG within the normal range was associated with MetS, and elderly subjects with high normal levels have a higher incidence of developing T2D for both sexes, and CVD for females, over the short-term.
authors.affiliation: From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: C-L
authors.initials: CL
authors.lastname: Huang
authors.affiliation: From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: H-W
authors.initials: HW
authors.lastname: Chang
authors.affiliation: Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: J-B
authors.initials: JB
authors.lastname: Chang
authors.affiliation: From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: J-H
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: J-D
authors.initials: JD
authors.lastname: Lin
authors.affiliation: Division of Endocrinology and Metabolism, Cardinal Tien Hospital, New Taipei City, Taiwan and.
authors.forename: C-Z
authors.initials: CZ
authors.lastname: Wu
authors.affiliation: Division of Endocrinology and Metabolism, Cardinal Tien Hospital, New Taipei City, Taiwan and.
authors.forename: D
authors.initials: D
authors.lastname: Pei
authors.affiliation: From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Hung
authors.affiliation: From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Pathology, Cardinal Tien Hospital, New Taipei City, Taiwan.
authors.forename: Y-L
authors.initials: YL
authors.lastname: Chen
authors.affiliation: From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan 10324peter@gmail.com.
authors.forename: C-H
authors.initials: CH
authors.lastname: Hsieh
mesh_terms: D000368:Aged; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D013624:Taiwan / Q000453:epidemiology
chemical_list: D001786:Blood Glucose