Abstract P062: The Impact of High Fasting Plasma Glucose on Cardiovascular Health at the State-level in the United States

Abstract

Introduction: High fasting plasma glucose (FPG) is an established risk factor for cardiovascular disease (CVD). However, the impact of FPG on CVD mortality and morbidity at the state-level in the US has not been systematically evaluated. Objective: To quantify the number of CVD deaths and disability adjusted life years (DALYs) attributable to high FPG by age, sex, year and state among US adults from 1990 to 2016. Methods: We used a spatio-temporal Gaussian process regression (ST-GPR) to estimate the mean FPG level by age, sex, year and state. The inputs to the ST-GPR model included data from National Health and Nutrition Examination Survey, state-specific prevalence of obesity, and per-capita lag-distributed income in each state. Using the mean FPG and prevalence of diabetes in each state, we characterized the distribution of the FPG at the state-level. Then, we used the Global Burden of Disease study comparative risk assessment framework to estimate the CVD deaths and DALYs attributable to high FPG. Results: In 2016, there were 180,440 CVD deaths attributable to high FPG in the United States: 77% due to ischemic stroke, 21% due to cerebrovascular disease, and <1% due to peripheral artery disease. Alaska had the lowest attributable death rate for both males and females (66.9 per 100,000 and 55.4 per 100,000, respectively) and West Virginia had the highest attributable death rate for both males and females (227.3 per 100,000 and 186.4 per 100,000, respectively). This is contrasted to DALYS, where Colorado had the lowest attributable DALYS rate for both males and females (1,732 DALYS per 100,000 1,379 DALYS per 100,000, respectively) and West Virginia had the highest attributable DALY rate for both males and females (5,219 DALYS per 100,000 and 3,965 DALYS per 100,000, respectively). (Figure) Conclusions: Our results highlight the need for evidence-based intervention to control FPG to effectively prevent CVD.