An Overall Glance of Evidence Supportive of One-Hour and Two-Hour Postload Plasma Glucose Levels as Predictors of Long-Term Cardiovascular Events

Mann, Baldeep Kaur; Bhandohal, Janpreet; Hong, Jungrak

doi:10.1155/2019/6048954

Cited by 7 publications

(5 citation statements)

References 60 publications

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“…[ 38 , 39 ] Therefore, both 1hPG and 2hPG are important in predicting long-term cardiovascular disease. [ 40 ] Third, 2hPG was based on OGTT, and our results cannot, therefore, be applied to postprandial glucose. A postmeal hyperglycemic episode after breakfast was reported not to be predictive of cardiovascular events in patients with established CAD.…”

Section: Discussionmentioning

confidence: 99%

Newly diagnosed diabetes based on an oral glucose tolerance test predicts cardiovascular outcomes in patients with coronary artery disease: An observational study

Chen

Sheu

et al. 2022

Medicine

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Diabetes is prevalent in patients with coronary artery disease (CAD). Using the oral glucose tolerance test (OGTT), abnormal glucose regulation can be detected early in CAD patients without known diabetes. In the present study, we assessed the impact of abnormal glucose regulation on the long-term cardiovascular outcomes of patients with established CAD. Patients hospitalized for a scheduled angiography due to angina were enrolled in Taichung Veterans General Hospital. Fasting plasma glucose (FPG) and 2-hour postload glucose (2hPG) were assessed using the OGTT. Hemoglobin A1c (HbA1c) and other biochemical analyses were assessed using fasting blood samples. During a median follow-up period of 4.6 years, a composite of all-cause mortality, nonfatal myocardial infarction, and nonfatal stroke was recorded as the primary endpoint. In 682 enrolled patients who completed the follow-up, there were 16 myocardial infarction events, 12 stroke events, and 58 deaths as composite endpoints. According to FPG and 2hPG, patients with newly diagnosed diabetes had a 2-fold higher risk for the composite endpoint than those in the normal glucose group (hazard ratio [HR], 2.011; 95% confidence interval (CI), 1.101–3.673; P = .023); however, prediabetes was not significantly associated with the composite endpoint (HR, 1.452; 95% CI, 0.788–2.675; P = .232). On the other hand, patients with diabetes diagnosed by FPG and HbA1c did not have a significantly higher risk for the composite endpoint than those in the normal glucose group (HR, 1.321; 95% CI, 0.686–2.545; P = .405). A 2hPG ≥7.8 mmol/L was a significant predictor for the composite endpoint (odds ratio, 1.743; 95% CI, 1.060–2.863; P = .028) after adjusting for age, sex, and estimated glomerular filtration rate. Diabetes, but not prediabetes, detected via OGTT is associated with a significantly increased risk for the composite endpoint in patients with established CAD. The 2hPG provided a greater predictive power for the composite endpoint than fasting glucose and HbA1c.

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Section: Discussionmentioning

confidence: 99%

Newly diagnosed diabetes based on an oral glucose tolerance test predicts cardiovascular outcomes in patients with coronary artery disease: An observational study

Chen

Sheu

et al. 2022

Medicine

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“…A recent review of the literature has concluded that the postprandial glucose values are the main predictors of future CVD incidence, even in those without type 2 diabetes [ 4–6 , 20 ].Our study confirms the previous findings and highlights the significance of 1-h PG as the strongest determinant of CVD events and mortality. Such predictive capacity of 1-h PG was previously supported by the Malmö Preventive Project.…”

Section: Discussionmentioning

confidence: 99%

One-hour post-load glucose improves the prediction of cardiovascular events in the OPERA study

et al. 2021

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Background To estimate the ability of fasting, 1-h, and 2-h post-load glucose to predict cardiovascular outcomes. Methods We examined a population-based study consisting of 977 middle-aged subjects who underwent an oral glucose tolerance test with glucose values measured at 0, 60, and 120 min. Participants were followed up to 24 years, and cardiovascular outcomes were collected from national registers. Predictive abilities of fasting, 1-h, and 2-h glucose were evaluated alone and in the prediction models with traditional cardiovascular risk factors using Cox proportional hazard models, the likelihood-ratio test, Harrell's concordance index and integrated discrimination improvement. Results Cardiovascular endpoint occurred in 222 (22.7%) participants during a median follow-up of 19.8 years. In the prognostic models, 1-h glucose (HR 1.67, 95%CI 1.10–2.53), but not fasting or 2-h glucose, predicted cardiovascular events statistically significantly. In addition, when adding glucose parameters into the model including traditional cardiovascular risk factors, only 1-h glucose improved the predictive ability (LR-test p =.046). Finally, 1-h glucose found slightly over 50% more cardiovascular endpoints that were not recognized by fasting or 2-h glucose levels. Conclusions Our findings support the earlier ones suggesting that 1-h glucose would be a better long-term predictor of cardiovascular morbidity and mortality than fasting or 2-h glucose. KEY MESSAGES In addition to conventional CV risk factors,1-h but not fasting or 2-h post-load glucoses seems to be an independent predictor of cardiovascular events and seems to improve the predictive ability of the traditional cardiovascular risk model. Elevated 1-hpost-load glucose finds a large number (slightly over 50%)of cardiovascular endpoints that were not recognized by fasting or 2-h post-load glucose levels. One-hour glucose seems to be a better long-term predictor of cardiovascular morbidity and mortality than fasting or 2-h post-load glucose.

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“…A higher protein diet confers its benefits in several ways: (1) dietary protein has the highest thermic effect of feeding among the macronutrients, which improves energy balance for weight control purposes (Calcagno et al, 2019 ); (2) a meal higher in protein with concomitantly reduced carbohydrate content elicits lower postprandial glucose responses (Gannon & Nuttall, 2004 ; Nuttall & Gannon, 1991 ). Postprandial glucose response is not only the main determinant of the overall glucose control (i.e., hemoglobin A1c), but also an independent risk factor for the development of cardiovascular diseases (Mann et al, 2019 ; Monnier & Colette, 2006 ); and (3) a meal with higher protein and reduced carbohydrate content can improve blood lipid profiles by limiting substrate availability (i.e., carbohydrate) for de novo lipogenesis in the liver (Sanders & Griffin, 2016 ). Thus, an LC/HP diet may counteract some of the maladaptive physiological changes with SCI.…”

Section: Introductionmentioning

confidence: 99%

Effects of a low‐carbohydrate/high‐protein diet on metabolic health in individuals with chronic spinal cord injury: An exploratory analysis of results from a randomized controlled trial

Gower²,

McLain

et al. 2022

Physiological Reports

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An Overall Glance of Evidence Supportive of One-Hour and Two-Hour Postload Plasma Glucose Levels as Predictors of Long-Term Cardiovascular Events

Cited by 7 publications

References 60 publications

Newly diagnosed diabetes based on an oral glucose tolerance test predicts cardiovascular outcomes in patients with coronary artery disease: An observational study

Newly diagnosed diabetes based on an oral glucose tolerance test predicts cardiovascular outcomes in patients with coronary artery disease: An observational study

One-hour post-load glucose improves the prediction of cardiovascular events in the OPERA study

Effects of a low‐carbohydrate/high‐protein diet on metabolic health in individuals with chronic spinal cord injury: An exploratory analysis of results from a randomized controlled trial

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