Usefulness of Fasting Blood Glucose to Predict Vascular Outcomes Among Individuals Without Diabetes Mellitus (from the Northern Manhattan Study)

Eguchi, Kazuo; Boden-Albala, Bernadette; Jin, Zhezhen; Di Tullio, Marco R.; Rundek, Tatjana; Rodriguez, Carlos J.; Homma, Shunichi; Sacco, Ralph L.

doi:10.1016/j.amjcard.2007.06.032

« Previous Next »American Journal of Cardiology
Volume 100, Issue 9 , Pages 1404-1409, 1 November 2007

Usefulness of Fasting Blood Glucose to Predict Vascular Outcomes Among Individuals Without Diabetes Mellitus (from the Northern Manhattan Study)

Kazuo Eguchi, MD
- Center for Behavioral Cardiovascular Health, Division of General Medicine, Columbia University Medical Center, New York, New York
- Department of Cardiology, Columbia University College of Physicians and Surgeons, New York, New York
- Corresponding author: Tel: 212-342-3674; fax: 212-342-3431.
Bernadette Boden-Albala, DrPH
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, New York
- Department of Sociomedical Science, Mailman School of Public Health, Columbia University, New York, New York
Zhezhen Jin, PhD
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
Marco R. Di Tullio, MD
- Department of Cardiology, Columbia University College of Physicians and Surgeons, New York, New York
Tatjana Rundek, MD, PhD
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida.
Carlos J. Rodriguez, MD, MPH
- Department of Cardiology, Columbia University College of Physicians and Surgeons, New York, New York
Shunichi Homma, MD
- Department of Cardiology, Columbia University College of Physicians and Surgeons, New York, New York
Ralph L. Sacco, MD, MS
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida.
- Dr. Sacco was supported by NINDS grant R01 29993.

Received 11 April 2007; received in revised form 5 June 2007; accepted 5 June 2007.

It is still controversial whether fasting blood glucose (FBG) is associated with the risk of vascular outcomes among nondiabetic subjects. We sought to determine whether FBG is associated with vascular outcomes and whether this association differs among various racial or ethnic groups. In the Northern Manhattan Study, a total of 2,372 subjects (mean age 68.8 ± 10.7 years, 36% men) without a history of diabetes mellitus, stroke, or myocardial infarction (MI) were followed for an average of 7.5 years for ischemic stroke, MI, and combined vascular events defined as either ischemic stroke, MI, or vascular death. Cox proportional-hazards models were used to calculate hazard ratios and 95% confidence intervals (CIs) of FBG-associated risk for vascular outcomes after adjusting for age, gender, race/ethnicity, education, body mass index, hypertension, current smoking, previous coronary artery disease, low-density lipoprotein cholesterol, alcohol intake, and physical activity. The incidences of MI, ischemic stroke, and combined vascular events were 5.5, 6.3, and 20.0 per 1,000 person-years, respectively. Each SD increase of FBG (27 mg/dl) was associated with statistically significantly increased risks of combined vascular events (hazard ratio 1.20, 95% CI 1.09 to 1.31) and MI (hazard ratio 1.21, 95% CI 1.02 to 1.44), but the effect was weaker, evident for ischemic stroke (hazard ratio 1.13, 95% CI 0.95 to 1.34). FBG was significantly associated with incident ischemic stroke among African-American subjects (hazard ratio 1.38, 95% CI 1.09 to 1.74) and incident MI among Hispanic subjects (hazard ratio 1.24, 95% CI 0.99 to 1.55). In conclusion, FBG was an independent predictor for vascular outcomes among individuals without history of diabetes from this multiethnic cohort. The effects were more apparent for MI than for ischemic stroke; however, FBG was a strong predictor of ischemic stroke among African-American subjects.