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November 23, 2016BMJOpen Access

Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis

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Authors

XCXiaoyan CaiWMWeiyi MaiMLMeijun Li

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Overview

Meta-analysis reveals higher cardiovascular disease and all-cause mortality risks in populations with prediabetes, indicating health risks emerge even with modest glucose elevations.

Key Points

  • To assess the associations between different clinical definitions of prediabetes and the risks of composite cardiovascular disease, coronary heart disease, stroke, and all-cause mortality.
  • Meta-analysis of 53 prospective cohort studies comprising 1,611,339 participants from general populations with a median follow-up of 9.5 years.
  • Evaluated impaired fasting glucose (ADA: 5.6–6.9 mmol/L; WHO: 6.1–6.9 mmol/L), impaired glucose tolerance (2-hour glucose 7.8–11.0 mmol/L), and elevated HbA1c (ADA: 39–47 mmol/mol [5.7–6.4%]; NICE: 42–47 mmol/mol [6.0–6.4%]).
  • Compared with normoglycaemia, prediabetes increased composite cardiovascular disease risk (RR 1.13 for IFG-ADA, 1.26 for IFG-WHO, 1.30 for IGT) and all-cause mortality (RR 1.13 for IFG-ADA, 1.13 for IFG-WHO, 1.32 for IGT).
  • Prediabetes also increased risks of coronary heart disease (RR 1.10 for IFG-ADA, 1.18 for IFG-WHO, 1.20 for IGT) and stroke (RR 1.06, 1.17, and 1.20, respectively).
  • Elevated HbA1c increased the risk of composite cardiovascular disease (RR 1.21 for ADA, 1.25 for NICE) and coronary heart disease (RR 1.15 and 1.28, respectively), but showed no significant association with stroke or all-cause mortality.

Cite This Study

Cai et al. (2016) studied this question.

synapsesocial.com/papers/6a7fbdef138fa0ec199fece8https://doi.org/10.1136/bmj.i5953
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