Changes in fasting blood glucose status and incidence of cardiovascular disease: The China-PAR project
空腹血糖状态变化与心血管疾病发病率:中国动脉粥样硬化性心血管疾病预测项目
Ye Tong
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorFangchao Liu
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorKeyong Huang
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorJianxin Li
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorXueli Yang
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
Search for more papers by this authorJichun Chen
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorXiaoqing Liu
Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China
Search for more papers by this authorJie Cao
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorShufeng Chen
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorLing Yu
Department of Cardiology, Fujian Provincial Hospital, Fuzhou, China
Search for more papers by this authorYingxin Zhao
Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China
Search for more papers by this authorXianping Wu
Sichuan Center for Disease Control and Prevention, Chengdu, China
Search for more papers by this authorLiancheng Zhao
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorYing Li
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorDongsheng Hu
Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
Search for more papers by this authorJianfeng Huang
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorXiangfeng Lu
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorCorresponding Author
Chong Shen
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing, China
Correspondence
Dongfeng Gu, Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China.
Email: [email protected]
Chong Shen, Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Dongfeng Gu
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
School of Medicine, Southern University of Science and Technology, Shenzhen, China
Correspondence
Dongfeng Gu, Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China.
Email: [email protected]
Chong Shen, Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Email: [email protected]
Search for more papers by this authorYe Tong
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorFangchao Liu
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorKeyong Huang
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorJianxin Li
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorXueli Yang
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
Search for more papers by this authorJichun Chen
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorXiaoqing Liu
Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China
Search for more papers by this authorJie Cao
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorShufeng Chen
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorLing Yu
Department of Cardiology, Fujian Provincial Hospital, Fuzhou, China
Search for more papers by this authorYingxin Zhao
Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China
Search for more papers by this authorXianping Wu
Sichuan Center for Disease Control and Prevention, Chengdu, China
Search for more papers by this authorLiancheng Zhao
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorYing Li
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorDongsheng Hu
Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
Search for more papers by this authorJianfeng Huang
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorXiangfeng Lu
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Search for more papers by this authorCorresponding Author
Chong Shen
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing, China
Correspondence
Dongfeng Gu, Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China.
Email: [email protected]
Chong Shen, Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Dongfeng Gu
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
School of Medicine, Southern University of Science and Technology, Shenzhen, China
Correspondence
Dongfeng Gu, Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China.
Email: [email protected]
Chong Shen, Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Email: [email protected]
Search for more papers by this authorFunding information: Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, Grant/Award Numbers: 2017-I2M-1-004, 2019-I2M-2-003, 2021-I2M-1-010; National Key Research and Development Program of China, Grant/Award Numbers: 2017YFC0211703, 2018YFE0115300; National Natural Science Foundation of China, Grant/Award Numbers: 12126602, 82030102; Research Unit of Prospective Cohort of Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Grant/Award Number: 2019RU038
Abstract
enBackground
The effect of long-standing prediabetes or its transition on incident cardiovascular disease (CVD) is unclear. This study aimed to evaluate the association of changes in fasting blood glucose (FBG) status with the risk of developing CVD.
Methods
This research included 12 145 Chinese adults aged 35–74 years and free from diabetes mellitus (DM) at baseline. Study participants were cross-classified into six categories according to glucose at the first (1998–2001) and the second visit after 8 years: normal fasting glucose (NFG; 50–99 mg/dl), impaired FBG (IFG; 100–125 mg/dl), and DM. Cox proportional hazard regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for CVD associated with transition of glucose status.
Results
During a median follow-up of 5.5 years, 373 incident CVD cases occurred. Compared with participants remaining persistent NFG, a higher risk of developing CVD was identified among those remaining persistent IFG, progressing to DM from NFG or from IFG, with the multivariate-adjusted HR (95% CI) of 1.792 (1.141, 2.816), 1.723 (1.122, 2.645) and 1.946 (1.120, 3.381), respectively. Furthermore, when stratified by glucose status at baseline, persistent IFG and progression from IFG to DM still increased CVD risk in comparison with reversion from IFG to NFG, with the multivariate-adjusted HR (95% CI) of 1.594 (1.003, 2.532) and 1.913 (1.080, 3.389).
Conclusions
Participants with long-standing IFG and progressing to DM had a higher risk of developing CVD. Further well-designed studies are warranted to assess the association of other phenotypes or prediabetes duration with CVD.
摘要
zh背景:尚不清楚长期存在的糖尿病前期或其转变对心血管疾病(CVD)事件的影响。本研究旨在评估空腹血糖(FBG)状态变化与CVD发生风险之间的关系。
方法:本研究纳入了12145名35-74岁、基线时无糖尿病(DM)的中国成年人。研究参与者根据第一次(1998-2001年)和8年后第二次就诊时的血糖将其交叉分为6类:正常空腹血糖(NFG, 50-99 mg/dL)、空腹血糖受损(IFG, 100-125 mg/dL)和糖尿病。采用Cox比例风险回归模型估计CVD与葡萄糖状态转变相关的风险比(HR)和95%置信区间(CI)。
结果:在中位随访5.5年期间，共发生373例CVD病例。与持续存在NFG的参与者相比，在持续存在IFG、从NFG或IFG进展为DM的参与者中，发生CVD的风险更高，多变量校正HR (95% CI)分别为1.792(1.141,2.816)、1.723(1.122,2.645)和1.946(1.120,3.381)。此外，当按基线血糖状态分层时，与从IFG逆转到NFG相比，持续IFG和从IFG进展到DM仍增加CVD风险，多变量校正HR (95% CI)分别为1.594(1.003,2.532)和1.913(1.080,3.389)。
结论:长期存在IFG并发展为糖尿病的参与者发生CVD的风险更高。需要进一步精心设计研究，评估其他表型或糖尿病前期持续时间与CVD的相关性。
Supporting Information
| Filename | Description |
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| jdb13350-sup-0001-supinfo.docxWord 2007 document , 54.2 KB | Appendix S1. Supporting information. |
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