OBJECTIVES: To find the effect of change in fasting serum glucose on the risk of cardiovascular disease without type2 diabetes(T2DM).

METHODS: We analyzed the data of 149,913 Korean men aged ≥40 years without T2DM and history of cardiovascular disease at baseline using National Health Insurance Service database. Participants were first grouped into normal fasting glucose (NFG, 70.0-99.9mg/dL) and impaired fasting glucose (IFG, 100.0-125.9mg/dL) according to the fasting serum glucose levels of the first health screening. Then, the subjects were categorized into five groups which were ≤-25.0, -10.0 to -24.9, -9.9 to 9.9 (a persistent group, reference), +10.0 to +24.9, and ≥+25.0 mg/dL according to change in fasting serum glucose levels between the second and first health screenings. Cox proportional hazards regression analyses were performed to calculate the hazard ratios for the risk of myocardial infarction and stroke after adjusting for potential confounders.

RESULTS: Fasting serum glucose increasing ≥25.0mg/dL in the NFG group was associated with an elevated risk of stroke (adjusted hazard ratio, aHR 1.22, 95% confidential interval, CI 1.09-1.37). Fasting serum glucose increasing ≥25.0mg/dL in the IFG group was associated with an elevated risk of myocardial infarction (aHR 1.86, 95% CI 1.25-2.76) and stroke (aHR 1.34, 95% CI 1.09-1.66). Fasting serum glucose decreasing -10.0 to -24.9mg/dL in the NFG group was associated with an elevated risk of stroke (aHR 1.24, 95% CI 1.11-1.38), but decreasing fasting serum glucose in the IFG group was not significantly associated with the risk of myocardial infarction or stroke.

CONCLUSIONS: Maintaining fasting serum glucose at normal level may contribute to lowering the risk of cardiovascular disease.