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Post-challenge blood glucose concentration and stroke mortality rates in non-diabetic men in London: 38-year follow-up of the original Whitehall prospective cohort study

Batty, GD; Kivimaki, M; Smith, GD; Marmot, MG; Shipley, MJ; (2008) Post-challenge blood glucose concentration and stroke mortality rates in non-diabetic men in London: 38-year follow-up of the original Whitehall prospective cohort study. DIABETOLOGIA , 51 (7) 1123 - 1126. 10.1007/s00125-008-1005-0.

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Abstract

Aims/hypothesis While individuals with diabetes have a raised risk of stroke, it is unclear whether hyperglycaemia in non-diabetic populations is related to the development of this disease.Methods In this prospective cohort study of 19,019 men, capillary blood was drawn 2 h after consumption of a glucose preparation equivalent to 50 g of anhydrous dextrose. Study participants were then followed for mortality for a maximum of 38 years.Results During follow-up of 18,406 non-diabetic men, 13,116 deaths occurred (1,189 by stroke). Plots of stroke mortality rates versus blood glucose identified an upward inflection in risk of death from stroke at about 4.6 mmol/l. This upward inflection in risk could be adequately described using a single linear term above this threshold. A 1 mmol/l increase in blood glucose after this point was associated with a 27% increase in risk of death from stroke (hazard ratio 1.27, 95% CI 1.14-1.42). This increase in risk was partially attenuated by adjustment for covariates (1.17, 1.04-1.31) but remained statistically significant at conventional levels. Similar observations were made when all-cause mortality was the outcome of interest, although the magnitude of the association with blood glucose was somewhat lower.Conclusions/interpretation An incremental elevation in stroke mortality rates occurs with increasing post-challenge blood glucose.

Type:Article
Title:Post-challenge blood glucose concentration and stroke mortality rates in non-diabetic men in London: 38-year follow-up of the original Whitehall prospective cohort study
DOI:10.1007/s00125-008-1005-0
Keywords:blood glucose, mortality, stroke, Whitehall, CORONARY-HEART-DISEASE, NONFASTING SERUM GLUCOSE, RISK-FACTORS, POPULATION, TOLERANCE, WOMEN, RENFREW/PAISLEY, SCOTLAND, INSULIN
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of)
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care > Epidemiology and Public Health

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