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Hyperglycemia and arterial disease

H Keen, R J Jarrett, J H Fuller

    Diabetes
    |January 1, 1981
    PubMed
    Summary

    Diabetes mellitus (DM) increases atherosclerotic disease risk, but other mechanisms may be involved. Cardiovascular risk doubles sharply at the 95th percentile of blood sugar levels, particularly in women.

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    Area of Science:

    • Endocrinology and Metabolism
    • Cardiovascular Disease Research
    • Epidemiology

    Background:

    • Clinical and autopsy data link diabetes mellitus (DM) to increased atherosclerotic disease risk.
    • Mechanisms beyond arterial occlusion may explain some DM-related clinical syndromes.
    • Geographical variations exist in arterial disease frequency among diabetic populations.

    Purpose of the Study:

    • To investigate the relationship between glucose intolerance and atherosclerotic disease risk.
    • To examine potential non-atherosclerotic mechanisms contributing to DM-related cardiovascular events.
    • To assess gender-specific vulnerabilities in cardiovascular mortality associated with DM.

    Main Methods:

    • Analysis of clinical and autopsy evidence.
    • Review of geographical epidemiological data on arterial disease in diabetics.
    • Examination of morbidity and mortality data, including the Whitehall prospective study.
    • Statistical analysis of 2-hour post-glucose blood sugar levels and cardiovascular risk.

    Main Results:

    • Glucose intolerance, even without overt DM, is associated with increased atherosclerotic risk in certain populations.
    • Women exhibit particular vulnerability to DM-related cardiovascular morbidity and mortality.
    • Cardiovascular mortality risk shows a sharp doubling at the 95th percentile of 2-hour post-glucose blood sugar levels, not a smooth progression.

    Conclusions:

    • The link between diabetes mellitus and atherosclerotic disease is complex, involving factors beyond arterial occlusion.
    • Glucose intolerance represents a significant risk factor for cardiovascular disease, with varying prevalence across populations.
    • Targeting high blood sugar levels, especially in women and those exceeding the 95th percentile, is crucial for mitigating cardiovascular risk.

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