Long-term increase in fasting blood glucose is associated with increased risk of sudden cardiac arrest

초록

BackgroundDiabetes mellitus (DM) is associated with various cardiovascular complications, including sudden cardiac arrest (SCA). Furthermore, the severity of DM, as assessed by fasting blood glucose (FBG), is associated with the risk of SCA. However, whether long-term changes in FBG influence on SCA risk remains to be determined.MethodsThis study used sequential nationwide health screening data from 2009 and 2011. FBG was measured at each health screening, and Delta FBG was calculated as FBG in 2011-FBG in 2009.ResultsOverall, 2,801,153 people were analyzed, and the mean follow-up duration was 6.33 years. Compared with the euglycemic group (- 20 <= Delta FBG < 20), the 20 <= Delta FBG < 40, 40 <= Delta FBG < 100, and Delta FBG >= 100 groups had increased SCA risks of 25% (adjusted hazard ratio [HR] = 1.25; 95% confidence interval [CI] 1.16-1.35; p < 0.001), 66% (adjusted HR = 1.66; 95% CI 1.49-1.86; p < 0.001), and 2.9-fold (adjusted HR = 2.85; 95% CI 2.37-3.44; p < 0.001), respectively. The association between Delta FBG and SCA was maintained in people with DM but not in people without DM. However, sex, age, blood pressure, and presence of heart failure did not affect the association between Delta FBG and SCA. A decrease in Delta FBG over time was not associated with reduced risk of SCA: the adjusted HR was 1.11 (95% CI 0.98-1.27; p = 0.113) for the Delta FBG < -40 group and 1.12 (95% CI 1.03-1.22; p = 0.009) for the - 40 <= increment FBG < - 20 group.ConclusionsA long-term increase in Delta FBG can be associated with increased risk of SCA in people with DM. However, a long-term decrease in Delta FBG was not associated with reduced risk of SCA. Actions to prevent increase in FBG can have significant effects on public health in terms of SCA prevention.

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