Markers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review.

<h4>Background</h4>Associations between circulating markers of dysglycaemia and coronary heart disease (CHD) risk in people without diabetes have not been reliably characterised. We report new data from a prospective study and a systematic review to help quantify these associations.<h...

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Main Authors:	Nadeem Sarwar, Thor Aspelund, Gudny Eiriksdottir, Reeta Gobin, Sreenivasa Rao Kondapally Seshasai, Nita G Forouhi, Gunnar Sigurdsson, John Danesh, Vilmundur Gudnason
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Language:	EN
Published:	Public Library of Science (PLoS) 2010
Subjects:	Medicine R
Online Access:	https://doaj.org/article/a466bfa8cbb44f3faf15faf56f53e08e
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spelling	oai:doaj.org-article:a466bfa8cbb44f3faf15faf56f53e08e2021-12-02T19:56:12ZMarkers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review.1549-12771549-167610.1371/journal.pmed.1000278https://doaj.org/article/a466bfa8cbb44f3faf15faf56f53e08e2010-05-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20520805/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Associations between circulating markers of dysglycaemia and coronary heart disease (CHD) risk in people without diabetes have not been reliably characterised. We report new data from a prospective study and a systematic review to help quantify these associations.<h4>Methods and findings</h4>Fasting and post-load glucose levels were measured in 18,569 participants in the population-based Reykjavik study, yielding 4,664 incident CHD outcomes during 23.5 y of mean follow-up. In people with no known history of diabetes at the baseline survey, the hazard ratio (HR) for CHD, adjusted for several conventional risk factors, was 2.37 (95% CI 1.79-3.14) in individuals with fasting glucose > or = 7.0 mmol/l compared to those < 7 mmol/l. At fasting glucose values below 7 mmol/l, adjusted HRs were 0.95 (0.89-1.01) per 1 mmol/l higher fasting glucose and 1.03 (1.01-1.05) per 1 mmol/l higher post-load glucose. HRs for CHD risk were generally modest and nonsignificant across tenths of glucose values below 7 mmol/l. We did a meta-analysis of 26 additional relevant prospective studies identified in a systematic review of Western cohort studies that recorded fasting glucose, post-load glucose, or glycated haemoglobin (HbA(1c)) levels. In this combined analysis, in which participants with a self-reported history of diabetes and/or fasting blood glucose > or = 7 mmol/l at baseline were excluded, relative risks for CHD, adjusted for several conventional risk factors, were: 1.06 (1.00-1.12) per 1 mmol/l higher fasting glucose (23 cohorts, 10,808 cases, 255,171 participants); 1.05 (1.03-1.07) per 1 mmol/l higher post-load glucose (15 cohorts, 12,652 cases, 102,382 participants); and 1.20 (1.10-1.31) per 1% higher HbA(1c) (9 cohorts, 1639 cases, 49,099 participants).<h4>Conclusions</h4>In the Reykjavik Study and a meta-analysis of other Western prospective studies, fasting and post-load glucose levels were modestly associated with CHD risk in people without diabetes. The meta-analysis suggested a somewhat stronger association between HbA(1c) levels and CHD risk.Nadeem SarwarThor AspelundGudny EiriksdottirReeta GobinSreenivasa Rao Kondapally SeshasaiNita G ForouhiGunnar SigurdssonJohn DaneshVilmundur GudnasonPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 7, Iss 5, p e1000278 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Nadeem Sarwar Thor Aspelund Gudny Eiriksdottir Reeta Gobin Sreenivasa Rao Kondapally Seshasai Nita G Forouhi Gunnar Sigurdsson John Danesh Vilmundur Gudnason Markers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review.
description	<h4>Background</h4>Associations between circulating markers of dysglycaemia and coronary heart disease (CHD) risk in people without diabetes have not been reliably characterised. We report new data from a prospective study and a systematic review to help quantify these associations.<h4>Methods and findings</h4>Fasting and post-load glucose levels were measured in 18,569 participants in the population-based Reykjavik study, yielding 4,664 incident CHD outcomes during 23.5 y of mean follow-up. In people with no known history of diabetes at the baseline survey, the hazard ratio (HR) for CHD, adjusted for several conventional risk factors, was 2.37 (95% CI 1.79-3.14) in individuals with fasting glucose > or = 7.0 mmol/l compared to those < 7 mmol/l. At fasting glucose values below 7 mmol/l, adjusted HRs were 0.95 (0.89-1.01) per 1 mmol/l higher fasting glucose and 1.03 (1.01-1.05) per 1 mmol/l higher post-load glucose. HRs for CHD risk were generally modest and nonsignificant across tenths of glucose values below 7 mmol/l. We did a meta-analysis of 26 additional relevant prospective studies identified in a systematic review of Western cohort studies that recorded fasting glucose, post-load glucose, or glycated haemoglobin (HbA(1c)) levels. In this combined analysis, in which participants with a self-reported history of diabetes and/or fasting blood glucose > or = 7 mmol/l at baseline were excluded, relative risks for CHD, adjusted for several conventional risk factors, were: 1.06 (1.00-1.12) per 1 mmol/l higher fasting glucose (23 cohorts, 10,808 cases, 255,171 participants); 1.05 (1.03-1.07) per 1 mmol/l higher post-load glucose (15 cohorts, 12,652 cases, 102,382 participants); and 1.20 (1.10-1.31) per 1% higher HbA(1c) (9 cohorts, 1639 cases, 49,099 participants).<h4>Conclusions</h4>In the Reykjavik Study and a meta-analysis of other Western prospective studies, fasting and post-load glucose levels were modestly associated with CHD risk in people without diabetes. The meta-analysis suggested a somewhat stronger association between HbA(1c) levels and CHD risk.
format	article
author	Nadeem Sarwar Thor Aspelund Gudny Eiriksdottir Reeta Gobin Sreenivasa Rao Kondapally Seshasai Nita G Forouhi Gunnar Sigurdsson John Danesh Vilmundur Gudnason
author_facet	Nadeem Sarwar Thor Aspelund Gudny Eiriksdottir Reeta Gobin Sreenivasa Rao Kondapally Seshasai Nita G Forouhi Gunnar Sigurdsson John Danesh Vilmundur Gudnason
author_sort	Nadeem Sarwar
title	Markers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review.
title_short	Markers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review.
title_full	Markers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review.
title_fullStr	Markers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review.
title_full_unstemmed	Markers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review.
title_sort	markers of dysglycaemia and risk of coronary heart disease in people without diabetes: reykjavik prospective study and systematic review.
publisher	Public Library of Science (PLoS)
publishDate	2010
url	https://doaj.org/article/a466bfa8cbb44f3faf15faf56f53e08e
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Markers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review.

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