Postload Plasma Glucose and 30-Year Mortality Among Nondiabetic Middle-Aged Men From the General Population: The ERFORT Study

Abstract

The purpose of the study is to examine for the first time the association between 1-hour postload plasma glucose levels and known diabetes and 30-year total mortality. The population-based Erfurt Male Cohort Study of 1160 men aged 40 to 59 years was carried out between September 1973 and August 1975. A 1-hour postload venous blood sample was obtained after an oral glucose tolerance test in all nondiabetic subjects. Mortality follow-up continued until death or September 30, 2003. Only 25 subjects were lost to follow-up, but 595 study participants (51.3%) died. Survival curves for persons with diabetes, subjects with postload glucose levels greater than 200 mg/dL, and those with not elevated levels already start to diverge after 2 years in persons with diabetes, but only after 5 years in subjects with high postload glucose levels. After 30 years of follow-up, men with diabetes had an almost twofold risk for death (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.26-2.97) and men with a postload plasma glucose level greater than 200 mg/dL had a 1.5-fold increased risk for death (HR, 1.49; 95% CI, 1.17-1.88) compared with men in the lower-glucose-level group, even after multivariable adjustment. Postload hyperglycemia is a long-term predictor for all-cause mortality in middle-aged men without diabetes from the general population.