Objective To clarify the relationship of diabetes mellitus (DM) and impaired glucose tolerance (IGT) to the incidence of cardiovascular diseases (CVD) in Japanese general population.
Methods The Japan Arteriosclerosis Longitudinal Study Group conducted a meta-analysis of 20 cohort studies in Japan. We analysed a total of 42 427 general Japanese men and women with the information of glucose tolerance (serum glucose, haemoglobin A1c, and/or treatment for diabetes). The HRs and 95% CIs of CVD incidence (stroke or myocardial infarction) were estimated for DM and IGT using Poisson regression models.
Results The prevalence of DM was 7.1% and that of IGT was 13.8%. During the mean follow-up of 8.1 years, 247 incidence of myocardial infarction and 999 incidence of stroke were confirmed. The multivariate adjusted HRs (95% CIs) of CVD were 1.47 (1.20 to 1.80) for DM and 1.07 (0.90 to 1.27) for IGT. The multivariate adjusted HRs of myocardial infarction incidence were 1.49 (1.02 to 2.19) for DM and 0.83 (0.58 to 1.20) for IGT. The multivariate adjusted HRs of stroke were 1.43 (1.18 to 1.73) for DM and 1.11 (0.93 to 1.32) for IGT. DM also increased the risk of ischaemic stroke (the HR was 1.78 [1.39 to 2.27]); however, we did not find any significant relationships of DM to hemorrhagic stroke and subarachnoid haemorrhage.
Conclusion This large scale meta-analysis of Japanese confirmed that DM increased the incident risk of CVD, especially ischaemic stroke and myocardial infarction. IGT also tended to increase the risk of CVD incidence, although the risk was not statistically significant.
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