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Deshan Wu, Shuxiao Shi, Kexin Li, Victor W Zhong, Associations of Glycemic Measures in the Normal Range With All-Cause Mortality in the Absence of Traditional Risk Factors, The Journal of Clinical Endocrinology & Metabolism, Volume 110, Issue 5, May 2025, Pages e1508–e1515, https://doi.org/10.1210/clinem/dgae541
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Abstract
The investigation of the association between blood glucose within normal range and all-cause mortality among individuals without traditional risk factors is limited.
To determine the associations of 3 glycemic measures (fasting plasma glucose [FPG], hemoglobin A1c [HbA1c], and 2-hour glucose) in the normal range with all-cause mortality among individuals without traditional risk factors.
Retrospective cohort study of US National Health and Nutrition Examination Survey in 1988-1994 and 1999-2018. Nonpregnant adults who had a measurement of 2-hour glucose, FPG, and HbA1c, and absence of traditional risk factors were included. Cox proportional hazard models were performed to examine the associations of normal FPG (n = 5793), normal HbA1c (n = 8179), and normal 2-hour glucose (n = 3404) with all-cause mortality.
A significant association was found between 2-hour glucose within the normal range and all-cause mortality among those without traditional risk factors. Compared with participants with 2-hour glucose <80 mg/dL, participants with a higher normal 2-hour glucose level had a higher risk of all-cause mortality (110-139 mg/dL; HR 1.80, 95% CI 1.03-3.15). In the subgroup analysis, significant associations were also found among people aged ≥60 years and men. No significant associations were found between normal FPG and HbA1c levels and all-cause mortality.
Among US adults without traditional risk factors, high normal 2-hour glucose level was positively associated with all-cause mortality. This result highlights the potential importance of maintaining a lower normal level of 2-hour glucose for preventing mortality in individuals who are conventionally considered to be cardiovascular healthy.