Abstract 11425: Association of Glycemic Control With Cardiovascular Outcomes in Adult Cancer Survivors With Elevated Fasting Blood Glucose Level: A Population-Based Cohort Study

Abstract

Introduction: Management of blood glucose level is recommended for prevention of cardiovascular disease (CVD) and other health outcomes by well-regarded guidelines. However, whether glycemic control is associated with incident CVD in adult cancer survivors with elevated fasting blood glucose (FBG) level remains unknown. Hypothesis: We hypothesized that adult cancer survivors with elevated FBG level (FBG≥100 mg/dL) whose FBG level was lowered to the normal range (FBG<100 mg/dL) would be at lower risk of incident CVD compared to those whose FBG level was persistently elevated. Methods: Population-based cohort study derived from the National Health Insurance Service database identified adult cancer survivors between January 1, 2002 and December 31, 2005 who underwent the two consecutive biennial national health screening program (2007-2008 and 2009-2010) in the Republic of Korea. Follow-up data for incident CVD and death from CVD or other causes was obtained from the medical claims records and death registry, respectively. Each survivor was followed-up from January 1, 2011 to December 31, 2019 until incident CVD, death from CVD or other causes, whichever came first. The risk estimates for CVD outcomes were computed with Cox proportional hazards model adjusted for age, sex, insurance premium, lipid profile, hypertension, obesity, cigarette smoking, and physical activity among adult cancer survivors with and without glycemic control. Results: A total of 4,959 adult cancer survivors with elevated FBG level was identified in the NHIS database. Among these survivors, proportion of those whose FBG level was lowered to the normal range was 36.2% (n=1,785). After adjusting for sociodemographic, lifestyle, and clinical characteristics, adult cancer survivors with lowered FBG level compared to those who had persistently elevated FBG level were less likely to be at risk of incident CVD (adjusted hazard ratio=0.69; 95% confidence intervals: 0.24-1.98). Conclusions: No statistically significant risk estimate was observed in this analysis, which is likely to be underpowered. Well-designed observational studies are needed to examine the association of glycemic control with CVD events among adult cancer survivors with elevated FBG level.