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- Publisher Website: 10.1210/clinem/dgz173
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- PMID: 31679008
- WOS: WOS:000525870500018
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Article: Glycemic measures and risk of mortality in older Chinese: The Guangzhou Biobank Cohort Study
Title | Glycemic measures and risk of mortality in older Chinese: The Guangzhou Biobank Cohort Study |
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Authors | |
Keywords | adult aged all cause mortality biobank cardiovascular disease |
Issue Date | 2020 |
Publisher | Oxford University Press. The Journal's web site is located at https://academic.oup.com/jcem |
Citation | The Journal of Clinical Endocrinology & Metabolism, 2020, v. 105 n. 3, p. e181-e190 How to Cite? |
Abstract | Context:
China has the largest number of people with type 2 diabetes mellitus (T2DM) in the world. Data from previous studies have suggested that up to one-fifth of individuals with diabetes would be missed without an oral glucose tolerance test (OGTT). To date, there is little information on the mortality risk of these individuals.
Objective:
We estimated the association of different indicators of hyperglycemia with mortality in the general Chinese population.
Design:
Prospective cohort study.
Setting:
China.
Participants:
A total of 17 939 participants aged 50+ years.
Exposures:
Previously diagnosed diabetes and newly detected diabetes defined by fasting glucose (≥7.0 mmol/L), 2-hour postload glucose (≥11.1 mmol/L), or hemoglobin A1c (HbA1c, ≥6.5%).
Main Outcomes Measures:
Deaths from all-cause, cardiovascular disease, and cancer were identified by record linkage with death registration.
Results:
During 7.8 (SD, 1.5) years’ follow-up, 1439 deaths were recorded. Of 3706 participants with T2DM, 2126 (57%) had known T2DM, 118 (3%) were identified by isolated elevated fasting glucose, 1022 (28%) had isolated elevated postload glucose, and 440 (12%) had both elevated fasting and postload glucose. Compared with normoglycemia, the hazard ratio (95% confidence interval) of all-cause mortality was 1.71 (1.46-2.00), 0.96 (0.47-1.93), 1.43 (1.15-1.78), and 1.82 (1.35-2.45) for the 4 groups, respectively. T2DM defined by elevated HbA1c was not significantly associated with all-cause mortality (hazard ratio, 1.17; 95% confidence interval, 0.81-1.69).
Conclusion:
Individuals with isolated higher 2-h postload glucose had a higher risk of mortality by 43% than those with normoglycemia. Underuse of OGTT leads to substantial underdetection of individuals with a higher mortality risk and lost opportunities for early intervention. |
Persistent Identifier | http://hdl.handle.net/10722/283227 |
ISSN | 2021 Impact Factor: 6.134 2020 SCImago Journal Rankings: 2.206 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Jiang, CQ | - |
dc.contributor.author | Xu, L | - |
dc.contributor.author | Lam, TH | - |
dc.contributor.author | Jin, YL | - |
dc.contributor.author | Zhang, WS | - |
dc.contributor.author | Zhu, F | - |
dc.contributor.author | Thomas, GN | - |
dc.contributor.author | Cheng, KK | - |
dc.date.accessioned | 2020-06-22T02:53:43Z | - |
dc.date.available | 2020-06-22T02:53:43Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | The Journal of Clinical Endocrinology & Metabolism, 2020, v. 105 n. 3, p. e181-e190 | - |
dc.identifier.issn | 0021-972X | - |
dc.identifier.uri | http://hdl.handle.net/10722/283227 | - |
dc.description.abstract | Context: China has the largest number of people with type 2 diabetes mellitus (T2DM) in the world. Data from previous studies have suggested that up to one-fifth of individuals with diabetes would be missed without an oral glucose tolerance test (OGTT). To date, there is little information on the mortality risk of these individuals. Objective: We estimated the association of different indicators of hyperglycemia with mortality in the general Chinese population. Design: Prospective cohort study. Setting: China. Participants: A total of 17 939 participants aged 50+ years. Exposures: Previously diagnosed diabetes and newly detected diabetes defined by fasting glucose (≥7.0 mmol/L), 2-hour postload glucose (≥11.1 mmol/L), or hemoglobin A1c (HbA1c, ≥6.5%). Main Outcomes Measures: Deaths from all-cause, cardiovascular disease, and cancer were identified by record linkage with death registration. Results: During 7.8 (SD, 1.5) years’ follow-up, 1439 deaths were recorded. Of 3706 participants with T2DM, 2126 (57%) had known T2DM, 118 (3%) were identified by isolated elevated fasting glucose, 1022 (28%) had isolated elevated postload glucose, and 440 (12%) had both elevated fasting and postload glucose. Compared with normoglycemia, the hazard ratio (95% confidence interval) of all-cause mortality was 1.71 (1.46-2.00), 0.96 (0.47-1.93), 1.43 (1.15-1.78), and 1.82 (1.35-2.45) for the 4 groups, respectively. T2DM defined by elevated HbA1c was not significantly associated with all-cause mortality (hazard ratio, 1.17; 95% confidence interval, 0.81-1.69). Conclusion: Individuals with isolated higher 2-h postload glucose had a higher risk of mortality by 43% than those with normoglycemia. Underuse of OGTT leads to substantial underdetection of individuals with a higher mortality risk and lost opportunities for early intervention. | - |
dc.language | eng | - |
dc.publisher | Oxford University Press. The Journal's web site is located at https://academic.oup.com/jcem | - |
dc.relation.ispartof | The Journal of Clinical Endocrinology & Metabolism | - |
dc.rights | Pre-print: Journal Title] ©: [year] [owner as specified on the article] Published by Oxford University Press [on behalf of xxxxxx]. All rights reserved. Pre-print (Once an article is published, preprint notice should be amended to): This is an electronic version of an article published in [include the complete citation information for the final version of the Article as published in the print edition of the Journal.] Post-print: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in [insert journal title] following peer review. The definitive publisher-authenticated version [insert complete citation information here] is available online at: xxxxxxx [insert URL that the author will receive upon publication here]. | - |
dc.subject | adult | - |
dc.subject | aged | - |
dc.subject | all cause mortality | - |
dc.subject | biobank | - |
dc.subject | cardiovascular disease | - |
dc.title | Glycemic measures and risk of mortality in older Chinese: The Guangzhou Biobank Cohort Study | - |
dc.type | Article | - |
dc.identifier.email | Jiang, CQ: cqjiang@hkucc.hku.hk | - |
dc.identifier.email | Xu, L: linxu@hku.hk | - |
dc.identifier.email | Lam, TH: hrmrlth@hkucc.hku.hk | - |
dc.identifier.email | Zhang, WS: zhangws9@hku.hk | - |
dc.identifier.email | Thomas, GN: neilt@hkucc.hku.hk | - |
dc.identifier.email | Cheng, KK: chengkk@hkucc.hku.hk | - |
dc.identifier.authority | Xu, L=rp02030 | - |
dc.identifier.authority | Lam, TH=rp00326 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1210/clinem/dgz173 | - |
dc.identifier.pmid | 31679008 | - |
dc.identifier.scopus | eid_2-s2.0-85081739787 | - |
dc.identifier.hkuros | 310415 | - |
dc.identifier.volume | 105 | - |
dc.identifier.issue | 3 | - |
dc.identifier.spage | e181 | - |
dc.identifier.epage | e190 | - |
dc.identifier.isi | WOS:000525870500018 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0021-972X | - |