Hyperglycemia and Stroke Mortality Comparison between fasting and 2-h glucose criteria

OBJECTIVE — We investigated stroke mortality in individuals in different categories of glycemia and compared hazard ratios (HRs) corresponding to a 1-SD increase in 2-h plasma glucose and fasting plasma glucose (FPG) criteria. RESEARCH DESIGN ANDMETHODS — We examined data from 2-h 75-g oral glu-cose tolerance tests taken from 13 European cohorts comprising 11,844 (55%) men and 9,862 (45%) women who were followed up for a median of 10.5 years. A multivariate adjusted Cox proportional hazards model was used to estimate HRs for stroke mortality. RESULTS — In men and women without a prior history of diabetes, multivariate adjusted HRs for stroke mortality corresponding to a 1-SD increase in FPG were 1.02 (95 % CI 0.83–1.25) and 1.52 (1.22–1.88) and those in 2-h plasma glucose 1.21 (1.06–1.38) and 1.31 (1.06–1.61), respectively. Addition of 2-h plasma glucose to the model with FPG significantly improved prediction of stroke mortality in men (2 10.12; P 0.001) but not in women (2 0.01; P 0.94), whereas addition of FPG to 2-h plasma glucose improved stroke mortality in women (2 4.08; P 0.04) but not in men (2 3.29; P 0.07). CONCLUSIONS — Diabetes defined by either FPG or 2-h plasma glucose increases the ris