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Article: Glycemic measures and risk of mortality in older Chinese: The Guangzhou Biobank Cohort Study

TitleGlycemic measures and risk of mortality in older Chinese: The Guangzhou Biobank Cohort Study
Authors
Keywordsadult
aged
all cause mortality
biobank
cardiovascular disease
Issue Date2020
PublisherOxford 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?
AbstractContext: 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 Identifierhttp://hdl.handle.net/10722/283227
ISSN
2019 Impact Factor: 5.399
2015 SCImago Journal Rankings: 2.940

 

DC FieldValueLanguage
dc.contributor.authorJiang, CQ-
dc.contributor.authorXu, L-
dc.contributor.authorLam, TH-
dc.contributor.authorJin, YL-
dc.contributor.authorZhang, WS-
dc.contributor.authorZhu, F-
dc.contributor.authorThomas, GN-
dc.contributor.authorCheng, KK-
dc.date.accessioned2020-06-22T02:53:43Z-
dc.date.available2020-06-22T02:53:43Z-
dc.date.issued2020-
dc.identifier.citationThe Journal of Clinical Endocrinology & Metabolism, 2020, v. 105 n. 3, p. e181-e190-
dc.identifier.issn0021-972X-
dc.identifier.urihttp://hdl.handle.net/10722/283227-
dc.description.abstractContext: 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.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at https://academic.oup.com/jcem-
dc.relation.ispartofThe Journal of Clinical Endocrinology & Metabolism-
dc.rightsPre-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.subjectadult-
dc.subjectaged-
dc.subjectall cause mortality-
dc.subjectbiobank-
dc.subjectcardiovascular disease-
dc.titleGlycemic measures and risk of mortality in older Chinese: The Guangzhou Biobank Cohort Study-
dc.typeArticle-
dc.identifier.emailJiang, CQ: cqjiang@hkucc.hku.hk-
dc.identifier.emailXu, L: linxu@hku.hk-
dc.identifier.emailLam, TH: hrmrlth@hkucc.hku.hk-
dc.identifier.emailZhang, WS: zhangws9@hku.hk-
dc.identifier.emailThomas, GN: neilt@hkucc.hku.hk-
dc.identifier.emailCheng, KK: chengkk@hkucc.hku.hk-
dc.identifier.authorityXu, L=rp02030-
dc.identifier.authorityLam, TH=rp00326-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1210/clinem/dgz173-
dc.identifier.pmid31679008-
dc.identifier.scopuseid_2-s2.0-85081739787-
dc.identifier.hkuros310415-
dc.identifier.volume105-
dc.identifier.issue3-
dc.identifier.spagee181-
dc.identifier.epagee190-
dc.publisher.placeUnited States-

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