IMPAIRED GLUCOSE-TOLERANCE, DIABETES, AND CARDIOVASCULAR-DISEASE RISKFACTOR PROFILES IN THE ELDERLY - THE HONOLULU HEART PROGRAM

OBJECTIVE - The relationship between glucose tolerance status and othe r cardiovascular disease (CVD) risk factors was evaluated in a cohort of Japanese-American men (n = 3,741) ages 71-93 years who participated in the fourth examination oi the Honolulu Heart Program in 1991-1993. RESEARCH DESIGN AND METHODS - In this cross-sectional study, subjects were classified by reported diabetes and glucose tolerance status usi ng questionnaires and the World Health Organization (WHO) criteria, re spectively. RESULTS - The prevalence of reported diabetes was 17%. Amo ng the men who completed an oral glucose tolerance test and had no his tory oi diabetes (n = 1,900), 23% were diagnosed as diabetic and 39% h ad impaired glucose tolerance (IGT) by WHO criteria. The CVD risk fact or profiles of men with IGT and diabetes were significantly more adver se compared with men with normal glucose tolerance after adjustment fo r age. The rates of hypertension, mean levels of BMI, waist-io-hip rat io, triglycerides, and fasting insulin were higher in men with IGT and diabetes compared with normal subjects. Opposite trends were observed for HDL cholesterol. Two-hour insulin was significantly higher among men with IGT and previously undiagnosed diabetes. Men with known diabe tes had a lower physical activity index and higher fibrinogen levels t han normal subjects. No significant differences were observed For curr ent smoking and alcohol intake. Differences in risk factor levels by g lucose tolerance status remained after adjustment For age, physical ac tivity, BMI, and waist-to-hip ratio. CONCLUSIONS - These findings show that among elderly men of Japanese ancestry, impaired glucose toleran ce and undiagnosed and known diabetes are highly prevalent, and these conditions are associated with adverse CVD Factor profiles.