Abstract 824: The Relationships of Oral Glucose Tolerance Test With All-cause Mortality and Cardiovascular Diseases Mortality in a Prospective Urban Japanese Population: The Suita Study
Introduction: Recently type 2 diabetes (DM) has been a risk factor for cardiovascular diseases (CVD). However, few prospective studies have examined the relationships of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) with all-causes mortality, CVD, and cancers in general populations, especially in Asia. We assessed the hypothesis that the relationships of DM and IGT with all-cause mortality, CVD, and cancers were increased in a general urban Japanese cohort.
Methods: We studied 4,649 Japanese individuals (mean age 55.8 years old, without present illness of CVD or cancers at baseline) who completed a baseline survey and a 75g oral glucose tolerance test in during 1990 –1994 and were followed for an average of 13 years. The glucose categories were defined as followed: DM (fasting plasma glucose [FPG] >=126 mg/dL, 2 hours post-loaded glucose [2h-PG] >=200 mg/dL, or receiving medication for DM); IGT (FPG <126 mg/dL and 2h-PG 140 to 199 mg/dL); IFG (FPG 100 to 125 mg/dL and 2h-PG <140 mg/dL); and normal glucose tolerance [NGT] (FPG <100 mg/dL and 2h-PG <140 mg/dL). Cox proportional-hazard ratios (HRs) were fit for each glucose category after adjusting for age, body mass index, present illness of hypertension and hyperlipidemia, and smoking and drinking status at baseline survey.
Results: At the baseline survey, the frequencies of diabetes, IGT, and IFG were 9.1 %, 17.5 %, and 24.0 % for men and 4.6 %, 14.3 %, and 13.8 % for women, respectively. In 62,402 person-years of follow-up, we documented 676 deaths (including 153 CVD and 281 cancers). Compared with NGT, the multivariable HRs (95 % confidence intervals; 95 % CIs) of all-cause mortality in men were 1.1 (0.8 –1.4) in IFG, 1.0 (0.8 –1.3) in IGT, and 1.6 (1.2–2.1) in DM, whereas those in women were 1.4 (0.9 –2.0) in IFG, 1.5 (1.1–2.1) in IGT, and 1.8 (1.1–2.9) in DM. The multivariable HRs (95 % CIs) of CVD mortality in men and women combined were 1.4 (1.0 –2.1) in IFG+IGT and 2.1 (1.3–3.5) in DM, whereas those of cancer mortality were 1.2 (0.9 –1.5) in IFG+IGT and 2.0 (1.4 –2.9) in DM. The multivariable HRs (95 % CIs) of strokes for DM was 3.3 (1.4 –7.5).
Conclusions: DM is a risk factor for CVD, strokes, and cancers mortality. Postprandial hyperglycemia is a risk factor for all-cause mortality in general urban Japanese women.