University of Oulu

Anni Saunajoki, Juha Auvinen, Aini Bloigu, Olavi Ukkola, Sirkka Keinänen-Kiukaanniemi & Markku Timonen (2021) One-hour post-load glucose improves the prediction of cardiovascular events in the OPERA study, Annals of Medicine, 53:1, 478-484, DOI: 10.1080/07853890.2021.1902557

One-hour post-load glucose improves the prediction of cardiovascular events in the OPERA study

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Author: Saunajoki, Anni1; Auvinen, Juha1,2; Bloigu, Aini1;
Organizations: 1Center for Life Course Health Research, University of Oulu, Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
3Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
4Healthcare and Social Services of Selänne, Pyhäjärvi, Finland
5Unit of General Practice, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2021041910876
Language: English
Published: Informa, 2021
Publish Date: 2021-04-19
Description:

Abstract

Background: To estimate the ability of fasting, 1-h, and 2-h post-load glucose to predict cardiovascular outcomes.

Methods: We examined a population-based study consisting of 977 middle-aged subjects who underwent an oral glucose tolerance test with glucose values measured at 0, 60, and 120 min. Participants were followed up to 24 years, and cardiovascular outcomes were collected from national registers. Predictive abilities of fasting, 1-h, and 2-h glucose were evaluated alone and in the prediction models with traditional cardiovascular risk factors using Cox proportional hazard models, the likelihood-ratio test, Harrell's concordance index and integrated discrimination improvement.

Results: Cardiovascular endpoint occurred in 222 (22.7%) participants during a median follow-up of 19.8 years. In the prognostic models, 1-h glucose (HR 1.67, 95%CI 1.10–2.53), but not fasting or 2-h glucose, predicted cardiovascular events statistically significantly. In addition, when adding glucose parameters into the model including traditional cardiovascular risk factors, only 1-h glucose improved the predictive ability (LR-test p=.046). Finally, 1-h glucose found slightly over 50% more cardiovascular endpoints that were not recognized by fasting or 2-h glucose levels.

Conclusions: Our findings support the earlier ones suggesting that 1-h glucose would be a better long-term predictor of cardiovascular morbidity and mortality than fasting or 2-h glucose.

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Series: Annals of medicine
ISSN: 0785-3890
ISSN-E: 1365-2060
ISSN-L: 0785-3890
Volume: 53
Issue: 1
Pages: 478 - 484
DOI: 10.1080/07853890.2021.1902557
OADOI: https://oadoi.org/10.1080/07853890.2021.1902557
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Subjects:
Funding: The study was supported by grants from the Emil Aaltonen Foundation, Orion Research Foundation sr, Oulu Medical Research Foundation and Diabetes Research Foundation. The funding sources had no role in the design or conduct of the study.
Copyright information: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  https://creativecommons.org/licenses/by/4.0/