Key result
Two-hour glucose levels were positively associated with systolic blood pressure (β = 2.23) before, but not after, adjusting for multiple testing, with no mediation by FGF21.
Why the study?
Although glucose levels are routinely used in diabetes, their relevance to blood pressure and vascular health in non-diabetic individuals remains underexplored.
Do plasma markers of glucose metabolism associate with blood pressure and arterial stiffness in non-diabetic adults, and does FGF21 mediate this relationship?
Cross-Sectional (n=228)
No
Do plasma markers of glucose metabolism associate with blood pressure and arterial stiffness in non-diabetic adults, and does FGF21 mediate this relationship?
Mean Difference: 2.23 (95% CI 0.29–4.17)
p-value: p=0.024
In non-diabetic adults, higher post-challenge glucose levels showed suggestive but non-significant associations with blood pressure and vascular function after multiple testing correction, with no mediating role for FGF21.
Associations in non-diabetics are hypothesis-generating; larger prospective studies needed to validate FGF21 mediation before clinical use.
Background and aims Although glucose levels are routinely used in the diagnosis and management of diabetes, their relevance in non-diabetic individuals remains underexplored. Considering the mediating role of fibroblast growth factor 21 (FGF21), this study examined the associations between plasma markers of glucose metabolism and blood pressure as well as vascular health in a population-based sample. Methods and results In 228 non-diabetic adults from the MEGA study, multivariable linear regression models were used to examine the associations of fasting glucose, two-hour glucose levels following an oral glucose tolerance test, and HbA1c with blood pressure (BP) parameters, pulse wave velocity, augmentation index (AIx), peripheral augmentation index (pAIx), and central aortic pressure. Effect modifications of age, sex, and BMI and the mediation mechanism of FGF21 were investigated. Two-hour glucose levels were positively associated with systolic BP [β = 2.23; 95% CI (0.29; 4.17); P = 0.024], mean arterial pressure [β = 1.70; 95% CI (0.07; 3.34); P = 0.042], diastolic BP [β = 1.48; 95% CI (0.06; 2.91); P = 0.041], and AIx [β = 0.96; 95% CI (0.06; 1.86); P = 0.037] before but not after adjusting for multiple testing. Furthermore, there was an association with systolic BP among non-obese individuals and with pAIx in participants younger than 40 years. No notable mediation effects of FGF21 were found in any of the associations. Conclusion In this population-based sample of non-diabetic adults, higher post-challenge glucose levels showed suggestive associations with blood pressure and vascular function, particularly in non-obese individuals and younger participants. However, these associations did not remain statistically significant after correction for multiple testing, indicating that the findings should be interpreted cautiously.
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Zakic et al. (2026) conducted a cross-sectional in Non-diabetic adults (n=228). Two-hour plasma glucose levels following an oral glucose tolerance test was evaluated on Systolic blood pressure (SBP) (β = 2.23, 95% CI 0.29; 4.17, p=0.024). Two-hour glucose levels were positively associated with systolic blood pressure (β = 2.23) before, but not after, adjusting for multiple testing, with no mediation by FGF21.
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