Diabetes and Cardiovascular Disease in a Prospective Population Survey in Japan: The Hisayama Study

Author:

Fujishima Masatoshi1,Kiyohara Yutaka1,Kato Isao1,Ohmura Takao1,Iwamoto Hiromitsu1,Nakayama Keizo1,Ohmori Susumu1,Yoshitake Taketo1

Affiliation:

1. Second Department of Internal Medicine, Faculty of Medicine, Kyushu University Fukuoka, Japan

Abstract

To elucidate the effect of glucose intolerance on cardiovascular disease in the current Japanese population, we performed a 75-g oral glucose tolerance test in 2,427 Hisayama residents aged 40–79 years in 1988, who were free from a previous history of stroke or myocardial infarction, and followed them prospectively for 5 years. The prevalence of diabetes (NIDDM) among men was 13% and that of impaired glucose tolerance (IGT) was 20%; the corresponding values for women were 9 and 19%, respectively. The age- and sex-adjusted incidence of cerebral infarction (6.5 per 1,000 person-years, P 0.01) and coronary heart disease (5.0 per 1,000 person-years, P 0.05) was significantly higher in subjects with NIDDM than in those with normal glucose tolerance (1.9 and 1.6 per 1,000 person-years, respectively). In addition, subjects with IGT and NIDDM had a higher risk of cardiovascular disease including stroke and coronary heart disease than did those with normal glucose tolerance after adjustment for age and sex, namely the relative risk for IGT was 1.9 (95% CI 1.2–3.2), and the relative risk for NIDDM was 3.0 (95% CI 1.8–5.2). These associations remained significant even after controlling for six other risk factors including hypertension in multivariate analysis. Our data suggest that NIDDM is a significant risk factor for both cerebral infarction and coronary heart disease and also that IGT itself is a risk factor for cardiovascular disease in the general Japanese population today.

Publisher

American Diabetes Association

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

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