Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment

摘要: Summary Background Cardiovascular mortality risk increases continuously with blood glucose, from concentrations well below conventional thresholds used to define diabetes. We aimed quantify population-level effects of all higher-than-optimum glucose on ischaemic heart disease and stroke worldwide. Methods population distribution fasting plasma measure exposure glucose. collated data in 52 countries individual-level records health surveys, systematic reviews, provided by investigators. Relative risks for were a meta-analysis more than 200 000 participants the Asia-Pacific region, adjustment other cardiovascular factors. Results In addition 959 000 deaths directly assigned diabetes, 1 490 000 709 000 attributable high accounting 21% 13% these conditions. 1·8 million 2·2 (84%) low-and-middle-income (1 224 000 disease, 623 000 stroke). 792 000 (53%) 345 000 (49%) that men. Largest numbers this factor South Asia (548 000) Europe Central (313 000), (215 000) East Pacific (190 000). Interpretation Higher-than-optimum is leading cause most world regions. Programmes diabetes management control at level need be closely integrated.