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A prospective study of low fasting glucose with cardiovascular disease events and all-cause mortality: The Women's Health Initiative.

Abstract While there is increasing recognition of the risks associated with hypoglycemia in patients with diabetes, few studies have investigated incident cause-specific cardiovascular outcomes with regard to low fasting glucose in the general population.
PMID
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Authors

Mayor MeshTerms
Keywords

Cardiovascular disease

Epidemiology

Fasting glucose

Heart failure

Journal Title metabolism: clinical and experimental
Publication Year Start




PMID- 28403935
OWN - NLM
STAT- MEDLINE
DA  - 20170413
DCOM- 20170419
LR  - 20170421
IS  - 1532-8600 (Electronic)
IS  - 0026-0495 (Linking)
VI  - 70
DP  - 2017 May
TI  - A prospective study of low fasting glucose with cardiovascular disease events and
      all-cause mortality: The Women's Health Initiative.
PG  - 116-124
LID - S0026-0495(17)30065-3 [pii]
LID - 10.1016/j.metabol.2017.02.010 [doi]
AB  - BACKGROUND: While there is increasing recognition of the risks associated with
      hypoglycemia in patients with diabetes, few studies have investigated incident
      cause-specific cardiovascular outcomes with regard to low fasting glucose in the 
      general population. OBJECTIVE: We hypothesized that low fasting glucose would be 
      associated with cardiovascular disease risk and all-cause mortality in
      postmenopausal women. METHODS: To test our hypothesis, we used both continuous
      incidence rates and Cox proportional hazards models in 17,287 participants from
      the Women's Health Initiative with fasting glucose measured at baseline.
      Participants were separated into groups based on fasting glucose level: low
      (<80mg/dL), normal/reference (80-99mg/dL), impaired (100-125mg/dL), and diabetic 
      (>/=126mg/dL). RESULTS: Participants were free of cardiovascular disease at
      enrollment, had mean age of 62years, and were 52% Caucasian, 24% African
      American, 8% Asian, and 12% Hispanic. Median follow-up was 15years. Graphs of
      continuous incidence rates compared to fasting glucose distribution exhibited
      evidence of a weak J-shaped association with heart failure and mortality that was
      predominantly due to participants with treated diabetes. Impaired and diabetic
      fasting glucose were positively associated with all outcomes. Associations for
      low fasting glucose differed, with coronary heart disease (HR=0.64 (0.42, 0.98)) 
      significantly inverse; stroke (0.73 (0.48, 1.13)), combined cardiovascular
      disease (0.91 (0.73, 1.14)), and all-cause mortality (0.97 (0.79, 1.20)) null or 
      inverse and not significant; and heart failure (1.27 (0.80, 2.02)) positive and
      not significant. CONCLUSIONS: Fasting glucose at the upper range, but not the
      lower range, was significantly associated with incident cardiovascular disease
      and all-cause mortality.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Mongraw-Chaffin, Morgana
AU  - Mongraw-Chaffin M
AD  - Department of Medicine, University of California San Diego, San Diego, CA;
      Department of Epidemiology & Prevention, Wake Forest School of Medicine,
      Winston-Salem NC. Electronic address: [email protected]
FAU - LaCroix, Andrea Z
AU  - LaCroix AZ
AD  - Department of Family Medicine and Public Health, University of California San
      Diego, San Diego, CA.
FAU - Sears, Dorothy D
AU  - Sears DD
AD  - Department of Medicine, University of California San Diego, San Diego, CA;
      Department of Family Medicine and Public Health, University of California San
      Diego, San Diego, CA.
FAU - Garcia, Lorena
AU  - Garcia L
AD  - Department of Public Health Services, University of California Davis, Davis, CA.
FAU - Phillips, Lawrence S
AU  - Phillips LS
AD  - Atlanta VA Medical Center, Decatur, GA and Division of Endocrinology and
      Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta,
      GA.
FAU - Salmoirago-Blotcher, Elena
AU  - Salmoirago-Blotcher E
AD  - The Miriam Hospital Centers for Behavioral and Preventive Medicine at the Warren 
      Alpert Medical School, Brown University, Providence, RI.
FAU - Zaslavsky, Oleg
AU  - Zaslavsky O
AD  - School of Nursing, University of Washington, Seattle, WA.
FAU - Anderson, Cheryl A M
AU  - Anderson CA
AD  - Department of Family Medicine and Public Health, University of California San
      Diego, San Diego, CA.
LA  - eng
GR  - T32 HL079891/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20170216
PL  - United States
TA  - Metabolism
JT  - Metabolism: clinical and experimental
JID - 0375267
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Aged
MH  - Blood Glucose/*analysis
MH  - Cardiovascular Diseases/*epidemiology/etiology/mortality
MH  - Diabetes Mellitus
MH  - Fasting
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure
MH  - Humans
MH  - Hypoglycemia/complications
MH  - Incidence
MH  - Middle Aged
MH  - Mortality
MH  - Postmenopause
MH  - Prospective Studies
OTO - NOTNLM
OT  - Cardiovascular disease
OT  - Epidemiology
OT  - Fasting glucose
OT  - Heart failure
EDAT- 2017/04/14 06:00
MHDA- 2017/04/20 06:00
CRDT- 2017/04/14 06:00
PHST- 2016/06/01 [received]
PHST- 2017/02/03 [revised]
PHST- 2017/02/09 [accepted]
AID - S0026-0495(17)30065-3 [pii]
AID - 10.1016/j.metabol.2017.02.010 [doi]
PST - ppublish
SO  - Metabolism. 2017 May;70:116-124. doi: 10.1016/j.metabol.2017.02.010. Epub 2017
      Feb 16.

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