Abstract WP167: Low Fasting Blood Glucose and Risks of Vascular and Mortality Outcomes in General Population: A Systematic Review and Meta-Analysis

Abstract

Background and Purpose: Although low fasting blood glucose may imply poor nutrition status or hyperinsulinemia, whether low fasting blood glucose level increases future risks of stroke, cardiovascular disease, and mortality remain unsettled. We conducted a meta-analysis to examine the effect of low fasting blood glucose on subsequent major vascular outcomes in general populations without previous cardiovascular disease history. Methods: We searched PubMed and EMBASE from 1966 to June 2017. We included prospective cohort studies, which evaluated the effects of low and normal fasting glucose levels (4.7-5.5 mmol/L) on future risks of stroke, coronary heart disease, cardiovascular disease, and mortality. We analyzed data with cutoff levels of low fasting glucose level < 4.6 mmol/L and 4.0 mmol/L, respectively. Hazard ratio and 95 % confidence intervals were used to measure association between low fasting glucose levels and the risks of outcomes using random effect models. Results: We included 10 articles (consisting of 129 prospective cohort studies) that met our criteria; 3,277,497 participants were included in current meta-analysis. Comparing with the normal glucose group, low fasting blood glucose defined as < 4.6 mmol/L was not associated with the risk of stroke (adjusted HR 1.02, 0.99 to 1.06) or coronary heart disease (adjusted HR 1.02, 0.96 to 1.08), but was associated with an increased risk of all-cause mortality (adjusted HR 1.36, 1.06 to 1.75) (Fig 1 A), and total cardiovascular events (adjusted HR 1.03, 1.02 to 1.05). Using < 4.0 mmol/L as a cutoff level for low fasting blood glucose showed similar results (Fig 1B). Conclusions: Low fasting blood glucose is not associated with increased risk of stroke or coronary heart disease, but is associated with an increased all-cause mortality in the general population.