Fasting glucose level and all-cause or cause-specific mortality in Korean adults: a nationwide cohort study

Abstract

Background/Aims: Although people with diabetes have been shown to have higher mortality than people without diabetes, there is a lack of data on the association between fasting glucose (FG) levels and cause-specific mortality rates in the general population. Methods: A total of 326,547 Korean adults over 20 years of age, who had received a health checkup between 2006 and 2008 were selected from the Korean National Health Insurance Service sample cohort dataset and followed until 2015. We estimated hazard ratios (HRs) of all-cause mortality and cause-specific mortality relative to various range of FG levels. All causes of death were classified according to International Classification of Diseases (ICD)-10 codes. Results: During follow-up (mean, 8.5 years), a total of 13,536 deaths (mortality rate 4.89/1,000 person-year) occurred; 4,916 deaths from cancer, 2,133 from cardiovascular disease, 762 from infectious disease, 199 from renal disease, and 5,526 from other causes. The overall mortality rate increased with an increase in FG category (HR, 1.78; 95% confidence interval, 1.65 to 1.92; in the ≥ 160 mg/dL). In addition, a J-shaped associations was found between FG levels and all-cause mortality after adjustment for age, sex, smoking, drinking, physical activity, body mass index, diabetes mellitus medication, hypertension, and dyslipidemia. In particular, the risk of cancer-mortality with high FG levels was increased for men but not women. Conclusions: The risk of all-cause and cause-specific mortality showed the tendency to increase when the FG level was outside of the normal range, indicating a J-shaped relationship, in both men and women.

Young-onset type 2 diabetes in South Korea: a review of the current status and unmet need

“…In summary, we found that patients with YOD presented different phenotypes at diagnosis compared with those with late-onset T2DM. In particular, they tend to be more obese and have worse glycemic profiles, which is predicted to make the disease worse in the future, considering that the FPG level and BMI are important predictors of morbidity and mortality [ 47 ].…”

Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes

“…An increased risk of cardiovascular events has been reported in older patients with diabetes and particularly high comorbidities among those with low FBG levels (<95 mg/dL) [ 18 ]. In the general Korean population, the HR of all-cause mortality was significantly higher in the low (<70 mg/dL) and high FBG ranges (≥126 mg/dL) than in the reference range (80 to 99 mg/dL) [ 19 ]. In our study, we also a J-shaped association between FBG levels and all-cause mortality, as the range of 90 to 99 mg/dL was associated with the lowest risk of all-cause mortality.…”

“…In our study, we also a J-shaped association between FBG levels and all-cause mortality, as the range of 90 to 99 mg/dL was associated with the lowest risk of all-cause mortality. The exact mechanism underlying the relationship between low FBG levels and a high risk of mortality remains unclear, although one possibility is that low FBG levels could indicate poor nutritional status, liver dysfunction, or other undetectable illnesses [ 19 , 20 ].…”

Trends of severe hypoglycemia in patients with type 2 diabetes in Korea: A longitudinal nationwide cohort study

“…Hypertension was defined as diagnostic ICD‐10 codes (I10‐13 or I15) and at least one claim per year for antihypertensive medications. Dyslipidemia was defined as a diagnostic code (E78) and at least one claim per year for a lipid‐lowering agent 2 , 9 .…”