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KMID : 1155220160410040403
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Journal of the Korean Society of Health Information and Health Statistics
2016 Volume.41 No. 4 p.403 ~ p.410
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Fasting Blood Glucose Levels Trajectory and Risk of Cardiovascular Disease in Korean Population: National Health Insurance Service-National Sample Cohort (NHIS-NSC)
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Jeon Joo-Eun
Cho Eo-Rin
Jung Keum-Ji
Jee Sun-Ha
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Abstract
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Objectives: To classify trajectories of fasting blood glucose (FBS) levels and examine each trajectory`s associations with risk of cardiovascular disease (CVD).
Methods: The National Health Insurance Service-National Sample Cohort (NHIS-NSC) sampled in the 2002 NHIS database was followed until 2010, and 13,829 participants aged 20 years and above had conducted nationwide health examinations annually. We used Cox proportional hazards models to examine the association of trajectories to risk of CVD. Four distinct trajectory groups were identified for FBS: low-stable, moderate-stable, ele vated-upward, and High-upward.
Results: During 88947.9 person-years of follow-up (mean follow-up, 6.4 years), we documented 2,778 incident case of CVD. Age-standardized incidence rate were increased with FBS levels (5,296.2 in low-stable group, 6,292.6 in moderate-stable group, and 8047.9 in ele vated-upward group), but not in High-upward group. In multivariate models adjusted for age and sex, FBS was a significant predictor of CVD in elevated-upward group (hazard ratio (HR)=1.6, 95% confidence interval (CI):1.4-1.8) and High-upward group (HR=1.6, 95% CI:1.3-2.1). However, further adjust ment for clinical covariates, only elevated-upward group was significantly associated with CVD (HR=1.2, 95% CI:1.1-1.4).
Conclusions: Using the trajec tory approach, we found that elevated-upward and High-upward FBS trajectories were associated with greater risk of CVD. These findings indicate the importance of FBS management across the lifespan, prognostic assessments and the targeting of prevention strategies to high-risk individuals.
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KEYWORD
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Fasting blood sugar, Cardiovascular disease, Diabetes, Hypertension, Stroke
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