Mortality and Coronary Heart Disease in Women With Fasting Glucose Levels Within the Normal Range

Objective: Diabetic women have a greater relative risk of coronary heart disease than diabetic men. However, gender difference in the impact of blood glucose levels below diabetic range on risk of coronary heart disease is unclear. The aim of this study is to evaluate whether the association between nondiabetic blood glucose levels and the incident risk of coronary heart disease is different in men and women. Methods: We measured fasting serum glucose levels and other cardiovascular risk factors in 172,580 Koreans (108,461 men and 64,119 women), aged 35–59 years in 1990 and 1992. Our primary outcomes were hospital admissions and deaths from coronary heart disease in 11 year follow-up from 1993 to 2003. Cox proportional hazard models were used to estimate the hazard ratios for coronary heart disease according to the baseline fasting serum glucose levels, after adjustment for age, body mass index, blood pressure, total cholesterol level, and cigarette smoking. Results: During the 11 years, 3,769 coronary heart disease events occurred. Risk of coronary heart disease in men was significantly increased at fasting serum glucose levels of diabetic range (≥ 126 mg/dL), although risk of coronary heart disease in women was significantly increased from impaired fasting glucose levels ≥ 110 mg/dL. In fasting serum glucose levels ≥ 110 mg/dL, the hazard ratios for coronary heart disease incidence were higher in women than in men compared with women and men with fasting glucose levels <80mg/dL, respectively. There was no association between impaired fasting glucose from 100 to 109 mg/dL and risk of coronary heart disease neither in men nor in women. Conclusions: The stronger impact of fasting serum glucose levels on relative risk of coronary heart disease in women compared with in men was significant from impaired fasting glucose levels ≥ 110 mg/dL. Adjusted Hazard Ratios (HRs) for Coronary Heart Disease by Fasting Serum Glucose Levels

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Glucose levels in the normal range predict incident diabetes in families with premature coronary heart disease

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2006.03.021 ◽

2006 ◽

Vol 74 (3) ◽

pp. 267-273 ◽

Cited By ~ 5

Author(s):

Stasia S. Reynolds ◽

Lisa R. Yanek ◽

Dhananjay Vaidya ◽

Samia Mora ◽

Taryn F. Moy ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Incident Diabetes ◽

Normal Range ◽

Premature Coronary Heart Disease ◽

Glucose Levels

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Development of coronary heart disease and ischemic stroke in relation to fasting and 2-hour plasma glucose levels in the normal range

Cardiovascular Diabetology ◽

10.1186/1475-2840-11-76 ◽

2012 ◽

Vol 11 (1) ◽

pp. 76 ◽

Cited By ~ 22

Author(s):

Feng Ning ◽

Lei Zhang ◽

Jacqueline M Dekker ◽

Altan Onat ◽

Coen DA Stehouwer ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Ischemic Stroke ◽

Plasma Glucose ◽

Normal Range ◽

Glucose Levels

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Health Consequences and Management of Overweight and Obesity

Advances in Nutrition & Food Science ◽

10.33140/anfs.04.01.03 ◽

2019 ◽

Vol 4 (1) ◽

Keyword(s):

United States ◽

Coronary Heart Disease ◽

Heart Disease ◽

Life Expectancy ◽

Fasting Glucose ◽

Hdl Cholesterol ◽

Overweight And Obesity ◽

Glucose Levels ◽

Cholesterol Levels ◽

Low Hdl

Obesity is a complex, multi-factorial disease that is becoming increasingly common among adults and children worldwide. Once considered a problem only in developed countries, overweight and obesity are down dramatically on the rise in the developing countries as well, particularly in urban setting this is particular concern for health professionals because according to recent NIH study, obese individuals have 50 to 100 percent increased risk of premature death from all causes compared to normal weight individuals. The national heart lungs and blood institutes (NHLBI) clinical guideline on the identification evaluation and treatment of overweight and obesity in adults states “next to smoking, obesity is the second leading cause of preventable death in the World especially US today”. Obese individuals have second increased the risk of diabetes coronary heart disease, hyperlipidemia, hypertension, stroke, gallbladder disease, sleep apnea, osteoarthritis, respiratory problems and certain types of cancers(endometrial, breast, prostate and colon), all of which increase of mortality. The life expectancy of moderately obese person could be shortened by 2 to 5 years while the life expectancy of a morbidly obese man with a BMI greater than 40kg/m2 is likely to be reduced by almost thirteen years. The WHO predicts that death from diabetes complication will increase 50 percent worldwide in the United States. A report from the non-profit business group conference board suggests obesity is costing United States business $45 million annually in medical expenses and lost productivity. The NH estimates total costs for obesity treatment to be approximately $17 million. There is strong evidence that a modest weight loss of 10 percent of body weight will result in a reduction of blood pressure, fasting glucose and lipid levels. Treatment should be aggressive for obese individuals who have three or more of the following risk factors: cigarette smoking, hypertension, high LDL-cholesterol levels, low HDL cholesterol levels elevated fasting glucose levels and lipids levels, low HDL cholesterol levels, elevated fasting glucose levels and family history of coronary heart disease and age over 45 to 55 years for men and women respectively. The best way to prevent obesity is to change the setting of eating habits plus of daily routine by adding small changes in your life like using stairs instead of the elevator, drinking a lot of water, shifting to organic food, exposure of sunlight and 30 minutes exercise.

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The Stromelysin-1 5A/6A Promoter Polymorphism Is a Disease Marker for the Extent of Coronary Heart Disease

Disease Markers ◽

10.1155/2002/418383 ◽

2002 ◽

Vol 18 (3) ◽

pp. 121-128 ◽

Cited By ~ 21

Author(s):

Adelheid Schwarz ◽

Werner Haberbosch ◽

Harald Tillmanns ◽

Andreas Gardemann

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Total Sample ◽

Promoter Polymorphism ◽

Mean Values ◽

Glucose Levels ◽

Disease Marker ◽

Triple Vessel Disease ◽

Artery Disease ◽

Glucose Plasma

Background.Matrix metalloproteinases, such as stromelysin-1, are implicated in the pathogenesis of coronary artery disease (CAD) and acute myocardial infarction (MI). A 5A/6A promoter polymorphism can regulate the transcription of the stromelysin-1 gene in an allele-specific manner. Evidence has been presented that the 6A allele is associated with the progression of coronary heart disease (CHD). In contrast, the 5A allele may be linked to the risk of MI.Results.To analyse the relation of the 5A/6A polymorphism with the risk and severity of CHD and the risk of MI, a case-control study of 515 healthy controls and 1848 participants who underwent coronary angiography for diagnostic purposes was conducted. In the total sample, the mean CHD scores—according to Gensini—were different between 5A/6A genotypes: 5A5A homozygotes had the lowest, 6A6A genotypes the highest and 5A6A heterozygotes intermediate scores. These differences were even more pronounced when the participants were restricted to individuals with a high coronary risk profile (high apoB levels, high Lp(a) levels, high glucose levels, combinations of either high apoB and Lp(a) levels or high apoB, Lp(a) and glucose plasma levels). Mean values were used as cut points for high-risk populations, respectively. In contrast, the 5A allele was not associated with the risk of CHD or MI. Even when angiographically controlled individuals without MI were compared with MI patients in subpopulations of participants with no, single, double and triple vessel disease, the frequencies of the 5A/6A and/or the 5A5A genotypes were not higher in each subgroup, respectively.Conclusions.The present results do not confirm an association of the 5A allele with the risk of MI, observed in another investigation, but strengthen the hypothesis of earlier studies that the 6A allele is a disease marker for progression of coronary heart disease. Further investigations should evaluate whether 6A allele carriers and especially 6A homozygotes might benefit from a more aggressive therapy against CHD progression.

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Abstract P050: Glycated Hemoglobin Versus Fasting Glucose in Defining Metabolic Syndrome and Prediction of Coronary Heart Disease

Circulation ◽

10.1161/circ.127.suppl_12.ap050 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Julie K Bower ◽

Vijay Nambi ◽

Mariana Lazo ◽

Andreea Rawlings ◽

Meredith C Foster ◽

...

Keyword(s):

Metabolic Syndrome ◽

Coronary Heart Disease ◽

Heart Disease ◽

Glycated Hemoglobin ◽

Fasting Glucose ◽

Cox Proportional Hazards ◽

Diabetes Diagnosis ◽

The Metabolic Syndrome ◽

C Statistic ◽

Definition Of

Introduction. Fasting glucose (FG) is part of the Adult Treatment Panel III (ATP III) criteria for defining the metabolic syndrome (MetS). Glycated hemoglobin (HbA1c) is a measure of 2-3 month endogenous glucose exposure and is now recommended for diabetes diagnosis and screening for high-risk individuals. The aim of this study was to evaluate if replacing FG with HbA1c to define MetS improves prediction of incident coronary heart disease (CHD) in the Atherosclerosis Risk in Communities (ARIC) cohort. Methods. We included 11,194 ARIC participants without diabetes (based on diagnosis, medication use, FG ≥126 mg/dL, or HbA1c ≥6.5%) or prevalent CHD at baseline (1990-92). Cox proportional hazards models (adjusted for age, race, and study center) were used to compare the association between MetS defined using HbA1c (5.7-6.4%) or FG (100-125 mg/dL, based on ATP III guidelines) and risk of CHD (defined by myocardial infarction or fatal CHD, event data available through 2009). Results. Study participants had a mean age at baseline of 57 years, 43% were male, and 79% were white; median follow-up time was 16 years. Thirty-four percent of the study population had both normal FG (<100 mg/dL) and HbA1c (<5.7%), 37% had elevated FG and normal HbA1c, 4% had normal FG and elevated HbA1c, and 25% had both elevated FG (100-125 mg/dL) and HbA1c (5.7-6.4%). The association of combined FG and HbA1c categories with incident CHD are shown in the Figure. The adjusted hazard ratio predicting for incident CHD from MetS status was 1.43 (95% CI: 1.25-1.63, c-statistic: 0.61) using FG in the definition of MetS and 1.69 (95% CI: 1.48-1.93, c-statistic: 0.62) in the model replacing FG with HbA1c. Conclusions. Incorporating HbA1c into the definition of the MetS may help in identifying individuals who should be targeted for aggressive CHD risk factor reduction. Additionally, HbA1c may be useful clinically and in research settings for identifying individuals with MetS in cases where FG measures are not available.

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