Glucose levels in the normal range predict incident diabetes in families with premature coronary heart disease

Stasia S. Reynolds, Lisa R. Yanek, Dhananjay Vaidya, Samia Mora, Taryn F Moy, Christopher D. Saudek, Lewis C. Becker, Diane M. Becker

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Little is known about excess risk of incident diabetes conferred by fasting plasma glucose (FPG) within the normal range (<5.6 mmol/l) for high risk families. Methods: Healthy 30-59 year old non-diabetic siblings (N = 542) of index cases with documented premature coronary disease were followed prospectively for type 2 diabetes. Results: During 8.7 ± 3 years of follow-up, incident diabetes was identified in 7.8%. Rates were incremental with baseline non-diabetes FPG thresholds of 5.0, 5.6, 6.1, and 6.7 mmol/l (p for trend <0.0001). FPG was the strongest predictor of incident diabetes even across levels within the normal range. The multivariable adjusted relative risk was 14.9 (95% CI = 3.4-65.2) at FPG thresholds ≥5.0 mmol/l versus FPG <5.0 mmol/l. The maximal diagnostic efficiency for FPG was 5.50 mmol/l; with sensitivity and specificity 0.782. All FPG thresholds in the normal range between 5.0 and 5.6 mmol/l showed efficiency levels >0.74. The overall area under the ROC curve predicting incident diabetes for normal and prediabetes ranges of FPG was 0.867. Conclusion: Higher FPG levels within the designated "normal" range in high risk families are a potent independent risk factor for type 2 diabetes and may serve as a sentinel to trigger primary preventive interventions.

Original languageEnglish (US)
Pages (from-to)267-273
Number of pages7
JournalDiabetes Research and Clinical Practice
Volume74
Issue number3
DOIs
StatePublished - Dec 2006

Keywords

  • Coronary heart disease
  • Families
  • Incident diabetes
  • Prevention

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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