Abstract
We addressed whether or not the risk of coronary heart disease (CHD) in non-diabetic persons is linear at the lower end of fasting glucose levels. Middle-aged Turkish adults ( n = 2893) free from diabetes and CHD at baseline were studied prospectively over a 7.6-year follow-up. Participants with fasting glucose measurements were analyzed in 3 groups separated by 90 mg/dl and 110 mg/dl limits. Outcomes were analyzed by Cox regression. Cox regression for CHD incidence ( n = 374) showed an increased age-adjusted risk in the <90 mg/dl fasting glucose group ( n = 788) [HR 1.32 (1.03; 1.68)], compared with the 90–110 mg/dl group after adjustment for sex, age and the glucose groups. Further adjustment for waist circumference, C-reactive protein and conventional risk factors attenuated the HR to 1.27 ( p = 0.077). The risk profile in the low-glucose group could not be accounted for by age, smoking status, systolic blood pressure or fasting insulin levels but tended to show higher levels of circulating C-reactive protein. The increased CHD risk observed in individuals with lower compared with higher normal glucose concentrations is likely to be related to an associated pro-inflammatory state.
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