Lower FPG trajectory tied to lesser lifetime CVD risk

A significant association exists between fasting plasma glucose (FPG) trajectories and the lifetime risk of cardiovascular disease (CVD), reveals a study.

Specifically, “[b]oth decrease in FPG over time and consistently lower FPG over 4 years were associated with lower lifetime risk of CVD,” the investigators said.

The study included individuals without CVD at index ages 35 (n=72,324), 45 (n=62,049), and 55 years (n=38,113). The investigators measured FPG concentrations in 2006, 2008, and 2010 and identified the FPG trajectories by latent mixture modeling. Finally, they calculated the lifetime risk of CVD using the modified Kaplan-Meier method.

Five distinct FPG trajectories had been identified and named according to FPG range and changing pattern over time: low-stable, moderate-stable, moderate-increasing, elevated-decreasing, and elevated-stable. A total of 3,110 CVD events in men at index age 35 years were recorded during 371,219 person-years of follow-up and 357 CVD events in women during 107,447 person-years of follow-up.

Of the participants, those with the elevated-stable FPG pattern had the highest lifetime risk of CVD at 44.8 percent (95 percent confidence interval [CI], 37.8‒51.9), while those with the low-stable pattern had the lowest at 24.3 percent (95 percent CI, 23.3‒25.2).

At index age 55 years, individuals with the elevated-stable and elevated-decreasing FPG patterns showed similar original FPG concentrations, but those with the elevated-decreasing pattern (30.0 percent, 95 percent CI, 23.9‒36.1) had nearly one-third less lifetime CVD risk compared to those with elevated-stable pattern (43.6 percent, 95 percent CI, 31.8‒55.3).

“Few studies have used multiple measurements of FPG to examine the impact of long-term FPG trajectory patterns on lifetime risk of CVD,” the investigators noted.