Related Experiment Videos
Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program
Insights
Higher glucose levels one hour after a glucose challenge significantly increase the risk of fatal coronary heart disease (CHD). This increased risk for cardiovascular disease is evident even in individuals without diabetes.
Area of Science:
- Cardiovascular Disease Epidemiology
- Metabolic Health Research
Background:
- The Honolulu Heart Program has tracked cardiovascular disease (CVD) development in men of Japanese ancestry since 1965.
- Understanding early indicators of CVD risk is crucial for preventative strategies.
Purpose of the Study:
- To examine the association between post-challenge glucose levels and the risk of fatal coronary heart disease (CHD) and nonfatal myocardial infarction (MI).
Main Methods:
- A 12-year follow-up study of 6394 nondiabetic men aged 45-70 years from the Honolulu Heart Program.
- Analysis of glucose concentration 1 hour after a 50-g oral glucose challenge in relation to CVD events.
Main Results:
- Fatal CHD rates increased linearly with higher post-challenge glucose concentrations.
- Men in the highest glucose quintiles exhibited a two- to threefold increased risk of fatal CHD compared to the lowest quintile.
- This association remained significant after adjusting for traditional CVD risk factors.
Conclusions:
- A continuous, independent risk gradient exists between post-challenge glucose levels and subsequent coronary heart disease.
- Elevated glucose levels post-challenge are a significant predictor of fatal CHD, irrespective of other known risk factors.
Abstract:
Since 1965, the Honolulu Heart Program has followed 8006 men of Japanese ancestry, aged 45-70 yr at study entry, for the development of cardiovascular disease. To investigate the role of glucose concentration 1 h after a 50-g challenge on the risk of fatal coronary heart disease (CHD) and nonfatal myocardial infarction (MI), 6394 nondiabetic men were followed for 12 yr for the first development of CHD. The rate of fatal CHD increased linearly with amount of glucose. Men in the fourth quintile of postchallenge glucose (157-189 mg/dl) had twice the age-adjusted risk of fatal CHD of those in the lowest quintile (P less than .05). Relative risk increased to threefold among those in the top quintile and remained statistically significant after adjustment for other risk factors including body mass, total cholesterol, hypertension, left ventricular hypertrophy, and hematocrit (P less than .001). When glucose was considered as a linear term in the proportional hazards model, a highly significant relation was noted with fatal CHD alone and when combined with nonfatal MI (P less than .001). We conclude that a continuously increasing risk gradient exists between postchallenge glucose and subsequent CHD that is independent of other known risk factors.