Associations between fasting plasma glucose trajectories and cardiovascular disease among older Chinese adults

Abstract Background The aim of this study was to investigate the relationship between fasting plasma glucose (FPG) trajectories and the risk of cardiovascular disease (CVD) in the elderly population aged 65 years and above in China based on a community-based cohort study. Methods We included 7,079 participants aged 65 and above from a cohort based on the health examination data in Nanjing after following strict inclusion and exclusion criteria. FPG and other covariates were repeatedly measured from 2018 to 2020. The trajectory analysis model (GBTM) was used to construct the trajectories of fasting blood glucose index (FPG logarithm, so that it obeys the normal distribution). And the first cardiovascular disease in 2021 was used as the outcome event. A Cox proportional hazards model was used to examine the association between FPG trajectories and incident cardiovascular disease. Results We identified three FPG trajectories based on 2018 FPG measurement and change patterns during 2018-2020: low level (n=5,635), medium level (n=1,201), and high level (n=243). In 2021, we documented 70 incident cardiovascular disease events. Compared with the low-level group, groups with higher level FPG trajectories had a higher risk of CVD events. Adjusted HRs (95% CIs) were 1.63(0.94-2.85) for the medium-level group, and 2.79(1.19-6.52) for the high-level group. After further adjusting for metabolic indicators, we observed similar results. Among the 70 outcome events, there were 64 cases of stroke outcome events. And in the outcome event of stroke, we also found similar results, independent of age, sex and other covariates. Conclusions Higher levels of fasting plasma glucose trajectories were associated with a higher risk of cardiovascular disease or stroke outcomes in the elderly population in China.