Increased Vascular Disease Mortality Risk in Prediabetic Korean Adults Is Mainly Attributable to Ischemic Stroke. Issue 4 (April 2017)

• Record Type: Journal Article
• Authors: Kim, Nam Hoon; Kwon, Tae Yeon; Yu, Sungwook; Kim, Nan Hee; Choi, Kyung Mook; Baik, Sei Hyun; Park, Yousung; Kim, Sin Gon
• Is Part Of: Stroke. Volume 48:Issue 4(2017)
• Publication Date: 2017-04
• Subjects: diabetes mellitus -- glucose tolerance -- stroke; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.116.015947
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Purpose—: Prediabetes is a known risk factor for vascular diseases; however, its differential contribution to mortality risk from various vascular disease subtypes is not known. Methods—: The subjects of the National Health Insurance Service in Korea (2002–2013) nationwide cohort were stratified into normal glucose tolerance (fasting glucose <100 mg/dL), impaired fasting glucose (IFG) stage 1 (100–109 mg/dL), IFG stage 2 (110–125 mg/dL), and diabetes mellitus groups based on the fasting glucose level. A Cox regression analysis with counting process formulation was used to assess the mortality risk for vascular disease and its subtypes—ischemic heart disease, ischemic stroke, and hemorrhagic stroke. Results—: When adjusted for age, sex, and body mass index, IFG stage 2, but not stage 1, was associated with significantly higher all-cause mortality (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.18–1.34) and vascular disease mortality (HR, 1.27; 95% CI, 1.08–1.49) compared with normal glucose tolerance. Among the vascular disease subtypes, mortality from ischemic stroke was significantly higher (HR, 1.60; 95% CI, 1.18–2.18) in subjects with IFG stage 2 but not from ischemic heart disease and hemorrhagic stroke. The ischemic stroke mortality associated with IFG stage 2 remained significantly high when adjusted other modifiable vascular disease risk factors (HR, 1.51; 95% CI: 1.10–2.09) and medical treatments (HR, 1.75; 95% CI, 1.19–2.57). Conclusions—: Higher IFG degree (fasting glucose, 110–125 mg/dL) was associated with increased all-cause and vascular disease mortality. The increased vascular disease mortality in IFG stage 2 was attributable to ischemic stroke, but not ischemic heart disease or hemorrhagic stroke in Korean adults. Abstract : Supplemental Digital Content is available in the text.