Decreased Threshold of Fasting Serum Glucose for Cardiovascular Events: MASHAD Cohort Study.

Ali Javandoost,Sara Samadi,Mohammad Sadegh Khorrami Mohebbseraj,Zahra Asadi,Afsane Bahrami,Susan Darroudi,Najmeh Malekzadeh Gonabadi,Mohsen Mouhebati,Fatemehalsadat Jafari Sheshtamad,Farzad Rahmani,Alireza Heidari-Bakavol,Fatemeh Sadabadi,Habibollah Esmaeili,Aida Gholoobi,Gordon A Ferns ,Maryam Saberi‐Karimian ,Majid Ghayour‐Mobarhan

doi:10.29252/rbmb.9.1.64

Abstract

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally, and specifically in Iran. Generally, diabetes mellitus is the result of impaired glucose tolerance which together with dyslipidemia are considered as important risk factors of CVD. The aim of this study was to determine the relationship between fasting serum glucose (FSG), lipid profile and CVD endpoints, and to establish an optimal FSG cut-off in the MASHAD cohort study after nearly 6 years of follow-up. All the participants of MASHAD study were followed up for 6 years to determine their cardiovascular status. FSG, fasting lipids, and physical examinations were all recorded. To identify the optimal cut- off point of FSG, we carried out receiver operating curve (ROC) analysis. We determined MASHAD cutoff point of blood glucose as 90 mg/dl predicting the CVD outcome. The sensitivity and speciﬁcity of the FSG criterion were 54.34% and 71.68%, respectively. The AUC was 0.665 (95% CI 0.656-0.675, P< 0.0001). The adjusted hazard ratio show that FSG is associated with 2.34 increase in CVD risk using MASHAD cutoff point (HR 2.34, 95% 1.73-3.17, P< 0.001). These findings suggest that not only FSG and lipid profile are related to CVD outcome in the MASHAD study, but also elevated fasting glucose levels is strongly associated with cardiovascular events in this population. Besides, the fasting glucose at a threshold of 90 mg/dl can be used for screening cardiovascular events among the Iranian population.

Highlights

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally, and in Iran there has been a rising prevalence of CVD [1]
fasting serum glucose (FSG), TG, cholesterol, LDL-C, anthropometric indices and demographic data were significantly higher in subjects with CVD compared to those without (Table 1)
CVD MASHAD Cohort Study shown in Fig. 1, we determined that the optimum cut-off point of serum glucose as 90 mg/dl in predicting CVD outcomes in the MASHAD population sample

Summary

Introduction

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally, and in Iran there has been a rising prevalence of CVD [1]. An impaired fasting glucose (IFG) is reported to be associated with an increased risk of CVD [3]. There has been a single study that has investigated the FPG cut-off threshold for determining a high risk of cardiovascular risk in the Iranian population [5], but there have been no studies that have assessed the FSG threshold for CVD outcomes in this population. The aim of this study was to determine the relationship between fasting serum glucose (FSG), lipid profile and CVD endpoints, and to establish an optimal FSG cut-off in the MASHAD cohort study after nearly 6 years of follow-up. Conclusions: These findings suggest that FSG and lipid profile are related to CVD outcome in the MASHAD study, and elevated fasting glucose levels is strongly associated with cardiovascular events in this population. The fasting glucose at a threshold of 90 mg/dl can be used for screening cardiovascular events among the Iranian population

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Conclusion