Key result
Two-hour post-glucose at the 95th percentile linked to ~2-fold higher CV mortality.
Why the study?
The increased risk of atherosclerotic disease in diabetes mellitus and glucose intolerance varies geographically and may involve mechanisms beyond arterial occlusion, with particular vulnerability in women.
Does glucose intolerance increase the risk of cardiovascular mortality?
Does glucose intolerance increase the risk of cardiovascular mortality?
Cardiovascular mortality risk does not rise smoothly with glucose intolerance but doubles sharply at the 95th percentile of 2-hour post-glucose blood sugar.
Caution against changing glucose thresholds from this cohort alone; leaves open need for prospective validation across populations.
Clinical and autopsy evidence support the increased risk of atherosclerotic disease in diabetes mellitus (DM). However, mechanisms other than arterial occlusion may also contribute to clinical syndromes often assumed to be atherosclerotic in origin. There is considerable geographical variability in the frequency of arterial disease in the diabetic. Glucose intolerance short of unequivocal DM is found in some (though not all) populations to carry increased atherosclerotic risk. Morbidity and mortality data suggest that women are particularly vulnerable (as with DM). The Whitehall prospective study of cardiovascular mortality shows that risk does not rise smoothly with increasing degrees of glucose intolerance but that it doubles sharply at the 95th percentile of the 2-h post-glucose blood sugar distribution.
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KEEN et al. (1981) conducted a review in Diabetes mellitus and glucose intolerance. Glucose intolerance was evaluated on Cardiovascular mortality. Cardiovascular mortality risk doubles sharply at the 95th percentile of the 2-hour post-glucose blood sugar distribution, rather than rising smoothly with increasing glucose intolerance.
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