"Normal" blood glucose and coronary risk

doi:10.1136/bmj.322.7277.5

BMJ 2001;322:5-6 ( 6 January )

Editorials

"Normal" blood glucose and coronary risk

Dose response effect seems consistent throughout the glycaemic continuum

Papers p 15

The first 150 words of the full text of this article appear below.

Although diabetes is a strong risk factor for coronary heart disease, the association between glycaemia within the "normalrange" and coronary heart disease has been somewhat controversial.¹A 1979 collaborative report from 15 countries found the risk ratioin the highest versus the lowest centile of glycaemia to rangefrom 0.34 to 6.07 in men from Finland, Denmark, France, the UnitedKingdom, and the United States.² In other cohort studies, includingWhitehall³ and Framingham,⁴ there appeared to be a thresholdeffect, with risk observed only at glucose levels approachingor including current diagnostic criteria for diabetes. There areseveral possible reasons for these contradictory results, including:the failure to exclude people with diabetes from the cohorts,compatible with a threshold effect; the multifactorial aetiologyof coronary heart disease, compatible with confounding; or thelarge intra-individual variation in glucose (especially postchallengeglucose) values, compatible with misclassificationbias.

Glycosylated haemoglobin, an integrated estimate of glucose over . . . [Full text of this article]

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