Normal fasting plasma glucose predicts type 2 diabetes and cardiovascular disease in elderly population in Taiwan

Chia Luen Huang, Hsiao Wen Chang, Jin Biou Chang, Jui-Hung Chen, Jiunn-Diann Lin, C. Z. Wu, D. Pei, Yi Jen Hung, Chien Hsing Lee, Yen Lin Chen, Chang Hsun Hsieh

Research output: Contribution to journalArticle

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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. Aim: 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. Design: 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.

Original languageEnglish
Article numberhcv204
Pages (from-to)515-522
Number of pages8
JournalQJM
Volume109
Issue number8
DOIs
Publication statusPublished - Aug 1 2016

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Taiwan
Type 2 Diabetes Mellitus
Fasting
Cardiovascular Diseases
Glucose
Population
ROC Curve
Incidence
Sex Characteristics
Hyperglycemia
Reference Values
Cohort Studies

ASJC Scopus subject areas

  • Medicine(all)

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Normal fasting plasma glucose predicts type 2 diabetes and cardiovascular disease in elderly population in Taiwan. / Huang, Chia Luen; Chang, Hsiao Wen; Chang, Jin Biou; Chen, Jui-Hung; Lin, Jiunn-Diann; Wu, C. Z.; Pei, D.; Hung, Yi Jen; Lee, Chien Hsing; Chen, Yen Lin; Hsieh, Chang Hsun.

In: QJM, Vol. 109, No. 8, hcv204, 01.08.2016, p. 515-522.

Research output: Contribution to journalArticle

Huang, CL, Chang, HW, Chang, JB, Chen, J-H, Lin, J-D, Wu, CZ, Pei, D, Hung, YJ, Lee, CH, Chen, YL & Hsieh, CH 2016, 'Normal fasting plasma glucose predicts type 2 diabetes and cardiovascular disease in elderly population in Taiwan', QJM, vol. 109, no. 8, hcv204, pp. 515-522. https://doi.org/10.1093/qjmed/hcv204
Huang, Chia Luen ; Chang, Hsiao Wen ; Chang, Jin Biou ; Chen, Jui-Hung ; Lin, Jiunn-Diann ; Wu, C. Z. ; Pei, D. ; Hung, Yi Jen ; Lee, Chien Hsing ; Chen, Yen Lin ; Hsieh, Chang Hsun. / Normal fasting plasma glucose predicts type 2 diabetes and cardiovascular disease in elderly population in Taiwan. In: QJM. 2016 ; Vol. 109, No. 8. pp. 515-522.
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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. Aim: 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. Design: 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.",
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T1 - Normal fasting plasma glucose predicts type 2 diabetes and cardiovascular disease in elderly population in Taiwan

AU - Huang, Chia Luen

AU - Chang, Hsiao Wen

AU - Chang, Jin Biou

AU - Chen, Jui-Hung

AU - Lin, Jiunn-Diann

AU - Wu, C. Z.

AU - Pei, D.

AU - Hung, Yi Jen

AU - Lee, Chien Hsing

AU - Chen, Yen Lin

AU - Hsieh, Chang Hsun

PY - 2016/8/1

Y1 - 2016/8/1

N2 - 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. Aim: 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. Design: 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.

AB - 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. Aim: 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. Design: 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.

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