Article Text
Abstract
Objectives Diabetes mellitus has been associated with stroke. However, the association between fasting blood glucose (FBG) and stroke risk in a general population remains not clear. The purpose of our study was to examine the FBG levels on subsequent stroke risk in a community-based cohort in China.
Design Prospective cohort study, employing Cox proportional hazard model to analyse the association of FBG levels with stroke risk.
Setting A community-based cohort study included adults participating in a baseline survey conducted in 2013 in Changshu, eastern China.
Participants 16 113 participants were recruited with a multistage sampling method, excluding participants with severe disability, severe cancer, severe psychiatric disturbance or previous stroke before enrolment.
Primary outcome measures Stroke events.
Results During a median follow-up of 5.5 years, 417 incident cases of stroke were identified. The adjusted HR for total and ischaemic stroke for participants in the fourth quartile of FBG compared with the first quartile was 1.44 (95% CI 1.07 to 1.94) and 1.57 (95% CI 1.11 to 2.21), respectively. FBG levels of ≥7.0 mmol/L were associated with an increased risk of stroke based on two clinical classifications (American Diabetes Association: 1.68 (1.24 to 2.27); WHO: 1.62 (1.21, 2.13)). In stratified analyses, risk associations existed in women (HR: 1.92, 95% CI 1.22 to 3.01) and postmenopausal women (HR: 1.68, 95% CI 1.06 to 2.68) for the fourth quartile versus the first. More importantly, the meta-analysis observed a positive association between FBG levels and stroke risk (pooled HR: 1.70, 95% CI 1.27 to 2.29; n=7)).
Conclusions Higher FBG level was independently associated with an increased risk of stroke in Chinese adults, especially significant in women.
- stroke
- diabetes & endocrinology
- epidemiology
Data availability statement
Data may be obtained from a third party and are not publicly available. The datasets generated and/or analyzed during the current study are not publicly available due to the restrictions of containing information that could compromise the privacy of research participants.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Statistics from Altmetric.com
Data availability statement
Data may be obtained from a third party and are not publicly available. The datasets generated and/or analyzed during the current study are not publicly available due to the restrictions of containing information that could compromise the privacy of research participants.
Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Footnotes
YZ and SG contributed equally.
Contributors Conceptualisation: YZ and HZ; methodology: YZ; software, YZ; validation: YZ; formal analysis: YZ; resources: SG, QZ, MY and ZZ; data curation: YZ; visualization: YZ; investigation: YZ, CW and DL; writing—original draft preparation: YZ and SG; writing—review and editing: YZ and HZ; supervision: HZ; project administration: HZ; funding acquisition: SG and HZ. All authors have agreed on the journal to which the article has been submitted and agreed to be accountable for all aspects of the work. All authors read and approved the final manuscript.
Funding This work was supported by the National Natural Science Foundation of China (number 81973122).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.