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Relation between blood glucose and coronary mortality over 33 years in the Whitehall study

Brunner, EJ; Shipley, MJ; Witte, DR; Fuller, JH; Marmot, MG; (2006) Relation between blood glucose and coronary mortality over 33 years in the Whitehall study. DIABETES CARE , 29 (1) 26 - 31.

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Abstract

OBJECTIVE - Glucose intolerance is a risk factor for coronary disease, but there is uncertainty about the shape of the dose-response relationship between glucose level and risk of coronary mortality. We examined the prospective relation of 2-h postload blood glucose (2hBG) with coronary and other major causes of mortality over 33 years.RESEARCH DESIGN AND METHODS - A 50-g oral glucose tolerance test (OGTT) was performed at baseline (1967-1969) in 17,869 male civil servants aged 40- 64 years.RESULTS - There were 3,561 coronary deaths during 451,787 person-years of observation. All-cause, cardiovascular, and respiratory mortality were elevated among participants with glucose intolerance. The hazard of coronary mortality rose from 2hBG = 4.6 mmol/l (83 mg/dI [95% CI 4.2-5.3]). The dose-response relation was best fitted by a single slope above this level, with no evidence of nonlinearity, compared with Cox models using other threshold levels, and those containing log 2hBG terms. There was no evidence for a close-response relationship below 2hBG = 4.6 mmolA. Between this level and 11.1 mmol/l (200 mg/dl), the age-adjusted hazard ratio was 3.62 (95% C12.3-5.6). The graded relationship was attenuated by 45% after adjustment for baseline coronary heart disease (CHD), BMI, systolic blood pressure, blood cholestero, smoking, physical activity, lung function, and employment grade.CONCLUSIONS - A threshold model with linear slope best described the dose-response relationship between postload blood glucose and CHD mortality risk.

Type: Article
Title: Relation between blood glucose and coronary mortality over 33 years in the Whitehall study
Keywords: MIDDLE-AGED MEN, CARDIOVASCULAR-DISEASE, DIABETES-MELLITUS, HEART-DISEASE, FOLLOW-UP, HELSINKI POLICEMEN, METABOLIC SYNDROME, NONDIABETIC MEN, PLASMA-GLUCOSE, TOLERANCE TEST
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: http://discovery.ucl.ac.uk/id/eprint/122352
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