Late nonfasting plasma glucose tied to CVD deaths

The risks of cardiovascular disease (CVD) mortality appear to be higher among adults with elevated late nonfasting plasma glucose (PG) levels independently of glycated haemoglobin (HbA1c), a recent study reports.

Drawing from the National Health and Nutrition Examination Surveys from 1988 to 2014, the researchers assessed 34,907 adults, of whom 1,965, 5,564, and 27,387 had PG measurements from the early nonfasting, late nonfasting, and fasting states, respectively.

Over a follow-up of 455,177 person-years (mean, 13.0 years), a total of 2,387 CVD deaths were recorded from data linkage with the National Death Index. Participants showed a mean PG of 102 mg/dL, which peaked during the second hour and decreased slightly and continuously thereafter.

Cox proportional hazards analysis revealed that PG was correlated significantly with CVD mortality regardless of fasting status: early nonfasting (hazard ratio [HR], 1.70, 95 percent confidence interval [CI], 1.23–2.35; p=0.001), late nonfasting (HR, 2.73, 95 percent CI, 2.09–3.58; p<0.001), and fasting (HR, 2.17, 95 percent CI, 1.79–2.63).

However, when adjusting for HbA1c, these interactions were attenuated, except that for late nonfasting PG, which remained a significant predictor for CVD deaths (HR, 1.73, 95 percent CI, 1.12–2.67; p=0.013).

A subanalysis of participants with late nonfasting PG data further revealed that beyond a cutoff value of 105, 110, or 115 mg/dL, elevated PG levels increased the risk of CVD mortality, even in those with normal HbA1c (<5.7 percent) or prediabetes (HbA1c 5.7 percent to 6.4 percent).