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The association between blood glucose value and long-term mortality
1Center of Family and Community Medicine, Karolinska Institutet, Alfred Nobels allé 12, S-141 83 Huddinge, Stockholm, Sweden. per.wandell@ki.se
Diabetes & Metabolism
|December 17, 2005
Summary
This study found that both very low and very high fasting blood glucose (FBG) levels are associated with increased total mortality risk. Low FBG may indicate poor health, highlighting the importance of monitoring glucose levels.
Area of Science:
- Endocrinology
- Epidemiology
- Public Health
Background:
- Fasting blood glucose (FBG) is a key indicator of glucose metabolism.
- Understanding the association between FBG levels and long-term mortality is crucial for public health.
- Previous studies have primarily focused on hyperglycemia, with less attention to hypoglycemia or very low FBG as mortality risk factors.
Purpose of the Study:
- To investigate the association between various fasting blood glucose (FBG) levels and all-cause mortality.
- To determine if both low and high FBG levels pose a risk for total mortality.
- To identify potential risk markers for poor health outcomes related to glucose regulation.
Main Methods:
- A cohort of 2,300 individuals aged 18-64 from Stockholm County (1969-70) was analyzed.
- FBG levels were categorized into six groups, including <3.0, 3.0-4.4, 4.5-5.5, 5.6-6.0, 6.1-6.6, and > 6.6 mmol/l, plus known diabetes.
- Participants were followed up until 1996 using the National Cause of Death Register, with Cox regression analysis adjusting for age, sex, care needs, hypertension, BMI, and smoking.
Main Results:
- Compared to the reference FBG of 5.6-6.0 mmol/l, significantly increased mortality risk was observed for known diabetes (HR 7.39), FBG > 6.6 mmol/l (HR 2.30), and FBG < 3.0 mmol/l (HR 3.44).
- The elevated mortality risk associated with low FBG (<3.0 mmol/l) and high FBG (>6.6 mmol/l) persisted after adjusting for multiple confounding factors including BMI and smoking.
- Low FBG levels (<3.0 mmol/l) were identified as a potential risk marker for poor health, independent of other known risk factors.
Conclusions:
- Both very low (<3.0 mmol/l) and very high (>6.6 mmol/l) fasting blood glucose levels are independently associated with an increased risk of total mortality.
- The increased mortality risk linked to low FBG suggests it may serve as a marker for underlying adverse health conditions.
- These findings underscore the importance of considering the full spectrum of glucose levels, including hypoglycemia, in assessing mortality risk and overall health status.
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