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Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies

Summary Background Uncertainties persist about the magnitude of associations of diabetes mellitus and fasting glucose concentration with risk of coronary heart disease and major stroke subtypes. We aimed to quantify these associations for a wide range of circumstances. Methods We undertook a meta-an... Full description

Journal Title: Lancet 2010, Vol.375 (9733), p.2215-2222
Main Author: Sarwar, N
Other Authors: Gao, P , Seshasai, S. R. Kondapally , Gobin, R , Kaptoge, S , Di Angelantonio, E , Ingelsson, E , Lawlor, D. A , Selvin, E , Stampfer, M , Stehouwer, C. D. A , Lewington, S , Pennells, L , Thompson, A , Sattar, N , White, I. R , Ray, K. K , Danesh, J
Format: Electronic Article Electronic Article
Language: English
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Quelle: Alma/SFX Local Collection
Publisher: Kidlington: Elsevier Ltd
ID: ISSN: 0140-6736
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title: Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies
format: Article
creator:
  • Sarwar, N
  • Gao, P
  • Seshasai, S. R. Kondapally
  • Gobin, R
  • Kaptoge, S
  • Di Angelantonio, E
  • Ingelsson, E
  • Lawlor, D. A
  • Selvin, E
  • Stampfer, M
  • Stehouwer, C. D. A
  • Lewington, S
  • Pennells, L
  • Thompson, A
  • Sattar, N
  • White, I. R
  • Ray, K. K
  • Danesh, J
subjects:
  • 11 Medical And Health Sciences
  • Abridged Index Medicus
  • Adult
  • Aged
  • Articles
  • ASIA-PACIFIC REGION
  • ATHEROSCLEROSIS
  • Biological and medical sciences
  • Blood Glucose
  • Blood Glucose - analysis
  • Blood pressure
  • Cardiovascular disease
  • CARDIOVASCULAR-DISEASES
  • Complications and side effects
  • Coronary Disease
  • Coronary Disease - etiology
  • CORONARY-HEART-DISEASE
  • Data collection
  • Diabetes
  • Diabetes Complications
  • Diabetes Complications - blood
  • Diabetes Mellitus
  • Diabetes Mellitus - blood
  • Diabetes. Impaired glucose tolerance
  • Endocrine pancreas. Apud cells (diseases)
  • Endocrinopathies
  • Estimates
  • Etiopathogenesis. Screening. Investigations. Target tissue resistance
  • Fasting
  • Female
  • General & Internal Medicine
  • General aspects
  • Heart attacks
  • Heart failure
  • Humans
  • Internal Medicine
  • Male
  • Medical and Health Sciences
  • Medical sciences
  • Medicin och hälsovetenskap
  • Middle Aged
  • MORTALITY
  • PATHOPHYSIOLOGY
  • Risk assessment
  • Risk Factors
  • Stroke
  • Stroke (Disease)
  • Stroke - etiology
  • Systematic review
  • TASK-FORCE
  • THERAPY
  • WOMEN
ispartof: Lancet, 2010, Vol.375 (9733), p.2215-2222
description: Summary Background Uncertainties persist about the magnitude of associations of diabetes mellitus and fasting glucose concentration with risk of coronary heart disease and major stroke subtypes. We aimed to quantify these associations for a wide range of circumstances. Methods We undertook a meta-analysis of individual records of diabetes, fasting blood glucose concentration, and other risk factors in people without initial vascular disease from studies in the Emerging Risk Factors Collaboration. We combined within-study regressions that were adjusted for age, sex, smoking, systolic blood pressure, and body-mass index to calculate hazard ratios (HRs) for vascular disease. Findings Analyses included data for 698 782 people (52 765 non-fatal or fatal vascular outcomes; 8·49 million person-years at risk) from 102 prospective studies. Adjusted HRs with diabetes were: 2·00 (95% CI 1·83–2·19) for coronary heart disease; 2·27 (1·95–2·65) for ischaemic stroke; 1·56 (1·19–2·05) for haemorrhagic stroke; 1·84 (1·59–2·13) for unclassified stroke; and 1·73 (1·51–1·98) for the aggregate of other vascular deaths. HRs did not change appreciably after further adjustment for lipid, inflammatory, or renal markers. HRs for coronary heart disease were higher in women than in men, at 40–59 years than at 70 years and older, and with fatal than with non-fatal disease. At an adult population-wide prevalence of 10%, diabetes was estimated to account for 11% (10–12%) of vascular deaths. Fasting blood glucose concentration was non-linearly related to vascular risk, with no significant associations between 3·90 mmol/L and 5·59 mmol/L. Compared with fasting blood glucose concentrations of 3·90–5·59 mmol/L, HRs for coronary heart disease were: 1·07 (0·97–1·18) for lower than 3·90 mmol/L; 1·11 (1·04–1·18) for 5·60–6·09 mmol/L; and 1·17 (1·08–1·26) for 6·10–6·99 mmol/L. In people without a history of diabetes, information about fasting blood glucose concentration or impaired fasting glucose status did not significantly improve metrics of vascular disease prediction when added to information about several conventional risk factors. Interpretation Diabetes confers about a two-fold excess risk for a wide range of vascular diseases, independently from other conventional risk factors. In people without diabetes, fasting blood glucose concentration is modestly and non-linearly associated with risk of vascular disease. Funding British Heart Foundation, UK Medical Research Council, and Pfizer.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
  • 1474-547X
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titleDiabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies
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creatorSarwar, N ; Gao, P ; Seshasai, S. R. Kondapally ; Gobin, R ; Kaptoge, S ; Di Angelantonio, E ; Ingelsson, E ; Lawlor, D. A ; Selvin, E ; Stampfer, M ; Stehouwer, C. D. A ; Lewington, S ; Pennells, L ; Thompson, A ; Sattar, N ; White, I. R ; Ray, K. K ; Danesh, J
creatorcontribSarwar, N ; Gao, P ; Seshasai, S. R. Kondapally ; Gobin, R ; Kaptoge, S ; Di Angelantonio, E ; Ingelsson, E ; Lawlor, D. A ; Selvin, E ; Stampfer, M ; Stehouwer, C. D. A ; Lewington, S ; Pennells, L ; Thompson, A ; Sattar, N ; White, I. R ; Ray, K. K ; Danesh, J ; Emerging Risk Factors Collaboration
descriptionSummary Background Uncertainties persist about the magnitude of associations of diabetes mellitus and fasting glucose concentration with risk of coronary heart disease and major stroke subtypes. We aimed to quantify these associations for a wide range of circumstances. Methods We undertook a meta-analysis of individual records of diabetes, fasting blood glucose concentration, and other risk factors in people without initial vascular disease from studies in the Emerging Risk Factors Collaboration. We combined within-study regressions that were adjusted for age, sex, smoking, systolic blood pressure, and body-mass index to calculate hazard ratios (HRs) for vascular disease. Findings Analyses included data for 698 782 people (52 765 non-fatal or fatal vascular outcomes; 8·49 million person-years at risk) from 102 prospective studies. Adjusted HRs with diabetes were: 2·00 (95% CI 1·83–2·19) for coronary heart disease; 2·27 (1·95–2·65) for ischaemic stroke; 1·56 (1·19–2·05) for haemorrhagic stroke; 1·84 (1·59–2·13) for unclassified stroke; and 1·73 (1·51–1·98) for the aggregate of other vascular deaths. HRs did not change appreciably after further adjustment for lipid, inflammatory, or renal markers. HRs for coronary heart disease were higher in women than in men, at 40–59 years than at 70 years and older, and with fatal than with non-fatal disease. At an adult population-wide prevalence of 10%, diabetes was estimated to account for 11% (10–12%) of vascular deaths. Fasting blood glucose concentration was non-linearly related to vascular risk, with no significant associations between 3·90 mmol/L and 5·59 mmol/L. Compared with fasting blood glucose concentrations of 3·90–5·59 mmol/L, HRs for coronary heart disease were: 1·07 (0·97–1·18) for lower than 3·90 mmol/L; 1·11 (1·04–1·18) for 5·60–6·09 mmol/L; and 1·17 (1·08–1·26) for 6·10–6·99 mmol/L. In people without a history of diabetes, information about fasting blood glucose concentration or impaired fasting glucose status did not significantly improve metrics of vascular disease prediction when added to information about several conventional risk factors. Interpretation Diabetes confers about a two-fold excess risk for a wide range of vascular diseases, independently from other conventional risk factors. In people without diabetes, fasting blood glucose concentration is modestly and non-linearly associated with risk of vascular disease. Funding British Heart Foundation, UK Medical Research Council, and Pfizer.
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subject11 Medical And Health Sciences ; Abridged Index Medicus ; Adult ; Aged ; Articles ; ASIA-PACIFIC REGION ; ATHEROSCLEROSIS ; Biological and medical sciences ; Blood Glucose ; Blood Glucose - analysis ; Blood pressure ; Cardiovascular disease ; CARDIOVASCULAR-DISEASES ; Complications and side effects ; Coronary Disease ; Coronary Disease - etiology ; CORONARY-HEART-DISEASE ; Data collection ; Diabetes ; Diabetes Complications ; Diabetes Complications - blood ; Diabetes Mellitus ; Diabetes Mellitus - blood ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Estimates ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Fasting ; Female ; General & Internal Medicine ; General aspects ; Heart attacks ; Heart failure ; Humans ; Internal Medicine ; Male ; Medical and Health Sciences ; Medical sciences ; Medicin och hälsovetenskap ; Middle Aged ; MORTALITY ; PATHOPHYSIOLOGY ; Risk assessment ; Risk Factors ; Stroke ; Stroke (Disease) ; Stroke - etiology ; Systematic review ; TASK-FORCE ; THERAPY ; WOMEN
ispartofLancet, 2010, Vol.375 (9733), p.2215-2222
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1Gao, P
2Seshasai, S. R. Kondapally
3Gobin, R
4Kaptoge, S
5Di Angelantonio, E
6Ingelsson, E
7Lawlor, D. A
8Selvin, E
9Stampfer, M
10Stehouwer, C. D. A
11Lewington, S
12Pennells, L
13Thompson, A
14Sattar, N
15White, I. R
16Ray, K. K
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0Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies
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descriptionSummary Background Uncertainties persist about the magnitude of associations of diabetes mellitus and fasting glucose concentration with risk of coronary heart disease and major stroke subtypes. We aimed to quantify these associations for a wide range of circumstances. Methods We undertook a meta-analysis of individual records of diabetes, fasting blood glucose concentration, and other risk factors in people without initial vascular disease from studies in the Emerging Risk Factors Collaboration. We combined within-study regressions that were adjusted for age, sex, smoking, systolic blood pressure, and body-mass index to calculate hazard ratios (HRs) for vascular disease. Findings Analyses included data for 698 782 people (52 765 non-fatal or fatal vascular outcomes; 8·49 million person-years at risk) from 102 prospective studies. Adjusted HRs with diabetes were: 2·00 (95% CI 1·83–2·19) for coronary heart disease; 2·27 (1·95–2·65) for ischaemic stroke; 1·56 (1·19–2·05) for haemorrhagic stroke; 1·84 (1·59–2·13) for unclassified stroke; and 1·73 (1·51–1·98) for the aggregate of other vascular deaths. HRs did not change appreciably after further adjustment for lipid, inflammatory, or renal markers. HRs for coronary heart disease were higher in women than in men, at 40–59 years than at 70 years and older, and with fatal than with non-fatal disease. At an adult population-wide prevalence of 10%, diabetes was estimated to account for 11% (10–12%) of vascular deaths. Fasting blood glucose concentration was non-linearly related to vascular risk, with no significant associations between 3·90 mmol/L and 5·59 mmol/L. Compared with fasting blood glucose concentrations of 3·90–5·59 mmol/L, HRs for coronary heart disease were: 1·07 (0·97–1·18) for lower than 3·90 mmol/L; 1·11 (1·04–1·18) for 5·60–6·09 mmol/L; and 1·17 (1·08–1·26) for 6·10–6·99 mmol/L. In people without a history of diabetes, information about fasting blood glucose concentration or impaired fasting glucose status did not significantly improve metrics of vascular disease prediction when added to information about several conventional risk factors. Interpretation Diabetes confers about a two-fold excess risk for a wide range of vascular diseases, independently from other conventional risk factors. In people without diabetes, fasting blood glucose concentration is modestly and non-linearly associated with risk of vascular disease. Funding British Heart Foundation, UK Medical Research Council, and Pfizer.
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jtitleLancet
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
au
0Sarwar, N
1Gao, P
2Seshasai, S. R. Kondapally
3Gobin, R
4Kaptoge, S
5Di Angelantonio, E
6Ingelsson, E
7Lawlor, D. A
8Selvin, E
9Stampfer, M
10Stehouwer, C. D. A
11Lewington, S
12Pennells, L
13Thompson, A
14Sattar, N
15White, I. R
16Ray, K. K
17Danesh, J
aucorpEmerging Risk Factors Collaboration
formatjournal
genrearticle
ristypeJOUR
atitleDiabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies
jtitleLancet
addtitleLancet
date2010
risdate2010
volume375
issue9733
spage2215
epage2222
pages2215-2222
issn
00140-6736
11474-547X
eissn1474-547X
codenLANCAO
notesMembers listed at end of paper
abstractSummary Background Uncertainties persist about the magnitude of associations of diabetes mellitus and fasting glucose concentration with risk of coronary heart disease and major stroke subtypes. We aimed to quantify these associations for a wide range of circumstances. Methods We undertook a meta-analysis of individual records of diabetes, fasting blood glucose concentration, and other risk factors in people without initial vascular disease from studies in the Emerging Risk Factors Collaboration. We combined within-study regressions that were adjusted for age, sex, smoking, systolic blood pressure, and body-mass index to calculate hazard ratios (HRs) for vascular disease. Findings Analyses included data for 698 782 people (52 765 non-fatal or fatal vascular outcomes; 8·49 million person-years at risk) from 102 prospective studies. Adjusted HRs with diabetes were: 2·00 (95% CI 1·83–2·19) for coronary heart disease; 2·27 (1·95–2·65) for ischaemic stroke; 1·56 (1·19–2·05) for haemorrhagic stroke; 1·84 (1·59–2·13) for unclassified stroke; and 1·73 (1·51–1·98) for the aggregate of other vascular deaths. HRs did not change appreciably after further adjustment for lipid, inflammatory, or renal markers. HRs for coronary heart disease were higher in women than in men, at 40–59 years than at 70 years and older, and with fatal than with non-fatal disease. At an adult population-wide prevalence of 10%, diabetes was estimated to account for 11% (10–12%) of vascular deaths. Fasting blood glucose concentration was non-linearly related to vascular risk, with no significant associations between 3·90 mmol/L and 5·59 mmol/L. Compared with fasting blood glucose concentrations of 3·90–5·59 mmol/L, HRs for coronary heart disease were: 1·07 (0·97–1·18) for lower than 3·90 mmol/L; 1·11 (1·04–1·18) for 5·60–6·09 mmol/L; and 1·17 (1·08–1·26) for 6·10–6·99 mmol/L. In people without a history of diabetes, information about fasting blood glucose concentration or impaired fasting glucose status did not significantly improve metrics of vascular disease prediction when added to information about several conventional risk factors. Interpretation Diabetes confers about a two-fold excess risk for a wide range of vascular diseases, independently from other conventional risk factors. In people without diabetes, fasting blood glucose concentration is modestly and non-linearly associated with risk of vascular disease. Funding British Heart Foundation, UK Medical Research Council, and Pfizer.
copKidlington
pubElsevier Ltd
pmid20609967
doi10.1016/S0140-6736(10)60484-9
oafree_for_read