Fasting plasma glucose and subsequent cardiovascular disease among young adults: Analysis of a nationwide epidemiological database
Fasting plasma glucose and subsequent cardiovascular disease among young adults: Analysis of a nationwide epidemiological database
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DOI：
10.1016/j.atherosclerosis.2020.12.024
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发表时间：
2021-01-16
期刊：
影响因子：
5.3
通讯作者：
Komuro, Issei
中科院分区：
文献类型：
--
作者：
Kaneko, Hidehiro;Itoh, Hidetaka;Komuro, Issei
背景和目的：利用全国流行病学数据库，我们旨在阐明年轻人中空腹血糖 (FPG) 与随后的心血管疾病 (CVD) 风险之间的关系。方法和结果：从日本医疗数据中心提取了 1,180,062 名既往没有 CVD 病史且未服用抗糖尿病药物的年轻人（20-49 岁）的医疗记录。我们将研究人群分为四组：正常、FPG 水平 100 mg/dL（1,007,747 人）、正常-高、FPG 水平 100-109 mg/dL（126,602 人）、空腹血糖受损 (IFG)、FPG 水平 110-125 mg/dL（32,451 人）和糖尿病 (DM)、FPG 水平126 mg/dL（13,262 人）。平均年龄为 39.7 +/- 6.9 岁，研究人群中 57.0% 为男性。平均随访期为 1201 +/- 905 天。多变量Cox回归分析显示，IFG（风险比[HR]；1.38）和DM（HR；2.09）会增加心肌梗死的风险。正常高（HR；1.11）、IFG（HR；1.18）和DM（HR；1.59）组心绞痛风险升高。与正常 FPG 水平相比，DM（HR；1.31）会增加中风风险。正常高水平（HR；1.10）、IFG（HR；1.22）和DM（HR；1.58）会增加心力衰竭的风险。 DM（HR；1.69）增加心房颤动的风险。结论：我们对全国流行病学数据库的分析表明，FPG 类别与随后的 CVD 风险密切相关。我们的结果证明了最佳 FPG 维持对于年轻人 CVD 一级预防的重要性。
Background and aims: Using a nationwide epidemiological database, we aimed to clarify the association of fasting plasma glucose (FPG) with subsequent cardiovascular disease (CVD) risk among young adults.Methods and results: Medical records of 1,180,062 young adults (20-49 years old) without a prior history of CVD and who were not taking antidiabetic medications were extracted from the Japan Medical Data Center. We categorized the study population into four groups: normal, FPG level 100 mg/dL (1,007,747 individuals), normal-high, FPG level of 100-109 mg/dL (126,602 individuals), impaired fasting glucose (IFG), FPG level of 110-125 mg/dL (32,451 individuals), and diabetes mellitus (DM), FPG level 126 mg/dL (13,262 individuals). The mean age was 39.7 +/- 6.9 years, and 57.0% of the study population were men. Mean follow-up period was 1201 +/- 905 days on average. Multivariable Cox regression analysis showed that IFG (hazard ratio [HR]; 1.38) and DM (HR; 2.09) increased the risk of myocardial infarction. Normal-high (HR; 1.11), IFG (HR; 1.18), and DM (HR; 1.59) groups had an elevated angina pectoris risk. DM (HR; 1.31) increased the risk of stroke compared to normal FPG levels. Normal-high levels (HR; 1.10), IFG (HR; 1.22) and DM (HR; 1.58) elevated the risk of heart failure. DM (HR; 1.69) increased the risk of atrial fibrillation.Conclusions: Our analysis of a nationwide epidemiological database demonstrated a close association of the FPG category with subsequent CVD risk. Our results exemplify the importance of optimal FPG maintenance for the primary prevention of CVD in young adults.