NONFASTING SERUM GLUCOSE AND THE RISK OF FATAL STROKE IN DIABETIC ANDNONDIABETIC SUBJECTS - 18-YEAR FOLLOW-UP OF THE OSLO STUDY

Background and Purpose The association between nonfasting serum glucos e and stroke mortality for diabetic and nondiabetic subjects is presen ted for participants of the Oslo Study. Methods The study started in 1 972; of 16 209 men aged 40 to 49 years, 16 172 had no previous history of stroke and 151 were known to be diabetic. Five diabetic and 80 non diabetic subjects died of stroke during the 18 years of follow-up, giv ing a rate ratio of 7.87 (95% confidence interval [CI], 2.48 to 19.14) . The rate of mortality for all causes in diabetic subjects was more t han five times that of those who were nondiabetic. Results Nonfasting serum glucose was a predictor of fatal stroke in all participants (dia betic subjects included) without a history of stroke in age-adjusted u nivariate analysis. The relative risk was 1.13 (CI, 1.03 to 1.25) by i ncrease of 1 mmol/L of serum glucose according to results of proportio nal hazards regression analysis. Accordingly, relative risk for nondia betic subjects was 1.02 (CI, 0.83 to 1.26) with no linear trend. The r ate ratio of the fifth quintile to the rest was 1.57 (CI, 0.94 to 2.56 ) for all participants and 1.28 (CI, 0.72 to 2.18) for nondiabetics. C onclusions There was an interaction between glucose level and body mas s index versus stroke for all participants but not for nondiabetic sub jects, with an increased risk for men with above-median values of gluc ose and body mass index. Analysis of nondiabetic subjects failed to sh ow glucose as a definite predictor of fatal stroke.