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Previous Volume 353:1454-1462 October 6, 2005 Number 14 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Arky, R. A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear Related Article PubMed Citation

ABSTRACT

Background The normal fasting plasma glucose level was recently defined as less than 100 mg per deciliter (5.55 mmol per liter). Whether higher fasting plasma glucose levels within this range independently predict type 2 diabetes in young adults is unclear.

Methods We obtained blood measurements, data from physical examinations, and medical and lifestyle information from men in the Israel Defense Forces who were 26 to 45 years of age.

Results A total of 208 incident cases of type 2 diabetes occurred during 74,309 person-years of follow-up (from 1992 through 2004) among 13,163 subjects who had baseline fasting plasma glucose levels of less than 100 mg per deciliter. A multivariate model, adjusted for age, family history of diabetes, body-mass index, physical-activity level, smoking status, and serum triglyceride levels, revealed a progressively increased risk of type 2 diabetes in men with fasting plasma glucose levels of 87 mg per deciliter (4.83 mmol per liter) or more, as compared with those whose levels were in the bottom quintile (less than 81 mg per deciliter [4.5 mmol per liter], P for trend <0.001). In multivariate models, men with serum triglyceride levels of 150 mg per deciliter (1.69 mmol per liter) or more, combined with fasting plasma glucose levels of 91 to 99 mg per deciliter (5.05 to 5.50 mmol per liter), had a hazard ratio of 8.23 (95 percent confidence interval, 3.6 to 19.0) for diabetes, as compared with men with a combined triglyceride level of less than 150 mg per deciliter and fasting glucose levels of less than 86 mg per deciliter (4.77 mmol per liter). The joint effect of a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or more and a fasting plasma glucose level of 91 to 99 mg per deciliter resulted in a hazard ratio of 8.29 (95 percent confidence interval, 3.8 to 17.8), as compared with a body-mass index of less than 25 and a fasting plasma glucose level of less than 86 mg per deciliter.

Conclusions Higher fasting plasma glucose levels within the normoglycemic range constitute an independent risk factor for type 2 diabetes among young men, and such levels may help, along with body-mass index and triglyceride levels, to identify apparently healthy men at increased risk for diabetes.

Source Information

From the Medical Corps Headquarters (A.T., E.I., T.S., I.K.) and the Center for Medical Services (D.T.-M.), Israel Defense Forces Medical Corps; the Department of Internal Medicine A, Sheba Medical Center, Tel-Hashomer (A.T.); the S. Daniel Abraham International Center for Health and Nutrition (I.S., A.R.), the Department of Epidemiology (I.S.), and the Department of Clinical Biochemistry (A.R.), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva; and the Department of Internal Medicine A, Meir Hospital, Sapir Medical Center, Kfar-Sava (D.P.) — all in Israel.

Drs. Tirosh and Shai contributed equally to the study.

Address reprint requests to Dr. Tirosh at the Department of Internal Medicine A, Sheba Medical Center, Tel-Hashomer, Israel, or at amirt{at}bgumail.bgu.ac.il.

Full Text of this Article

Related Letters:

Normal Fasting Plasma Glucose Levels and Type 2 Diabetes
Gambino R., Reichberg S., Schwartz J. G., Tirosh A., Shai I., Rudich A.
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N Engl J Med 2006; 354:87-88, Jan 5, 2006. Correspondence

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