Related Experiment Videos
Impaired glucose tolerance, diabetes, and cardiovascular disease risk factor profiles in the elderly. The Honolulu
B L Rodriguez1, J D Curb, C M Burchfiel
1Division of Clinical Epidemiology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu 96817, USA. beatnz@hhs.cba.hawaii.edu
Insights
Impaired glucose tolerance and diabetes are common in elderly Japanese-American men. These conditions are linked to increased cardiovascular disease risk factors, highlighting a need for targeted health interventions.
Area of Science:
- Gerontology
- Cardiovascular Disease Epidemiology
- Metabolic Health
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality in aging populations.
- Understanding the interplay between glucose metabolism and CVD risk factors is crucial for preventive strategies.
Purpose of the Study:
- To investigate the association between glucose tolerance status and various cardiovascular disease risk factors in elderly Japanese-American men.
- To determine the prevalence of impaired glucose tolerance and diabetes in this specific demographic.
Main Methods:
- A cross-sectional study analyzing data from 3,741 Japanese-American men (ages 71-93) from the Honolulu Heart Program (1991-1993).
- Classification of glucose tolerance status using World Health Organization (WHO) criteria based on questionnaires and oral glucose tolerance tests.
- Statistical adjustments for age, physical activity, body mass index (BMI), and waist-to-hip ratio.
Main Results:
- 17% of participants reported existing diabetes. Among those tested, 23% were diagnosed with diabetes and 39% with impaired glucose tolerance (IGT).
- Men with IGT and diabetes exhibited significantly more adverse CVD risk factor profiles, including higher rates of hypertension, BMI, waist-to-hip ratio, triglycerides, and fasting insulin.
- Lower HDL cholesterol and higher two-hour insulin levels were observed in men with IGT and undiagnosed diabetes. Known diabetes was associated with lower physical activity and higher fibrinogen.
Conclusions:
- Impaired glucose tolerance, undiagnosed diabetes, and known diabetes are highly prevalent in elderly Japanese-American men.
- These glucose metabolism abnormalities are significantly associated with unfavorable cardiovascular disease risk factor profiles.
- The findings underscore the importance of screening for glucose intolerance and managing associated risk factors in older Asian men.
Objective:
The relationship between glucose tolerance status and other cardiovascular disease (CVD) risk factors was evaluated in a cohort of Japanese-American men (n = 3,741) ages 71-93 years who participated in the fourth examination of the Honolulu Heart Program in 1991-1993.
Research Design And Methods:
In this cross-sectional study, subjects were classified by reported diabetes and glucose tolerance status using questionnaires and the World Health Organization (WHO) criteria, respectively.
Results:
The prevalence of reported diabetes was 17%. Among the men who completed an oral glucose tolerance test and had no history of diabetes (n = 1,900), 23% were diagnosed as diabetic and 39% had impaired glucose tolerance (IGT) by WHO criteria. The CVD risk factor profiles of men with IGT and diabetes were significantly more adverse compared with men with normal glucose tolerance after adjustment for age. The rates of hypertension, mean levels of BMI, waist-to-hip ratio, triglycerides, and fasting insulin were higher in men with IGT and diabetes compared with normal subjects. Opposite trends were observed for HDL cholesterol. Two-hour insulin was significantly higher among men with IGT and previously undiagnosed diabetes. Men with known diabetes had a lower physical activity index and higher fibrinogen levels than normal subjects. No significant differences were observed for current smoking and alcohol intake. Differences in risk factor levels by glucose tolerance status remained after adjustment for age, physical activity, BMI, and waist-to-hip ratio.
Conclusions:
These findings show that among elderly men of Japanese ancestry, impaired glucose tolerance and undiagnosed and known diabetes are highly prevalent, and these conditions are associated with adverse CVD factor profiles.