19 years after the paper in Diabetes care (previous post), an article in Circulation continues the story of Finnish policemen who were 34 - 64 years old and free of any cardiovascular disease (including CHD) & diabetes at the start of this study. Risk assessment at baseline is quite simple: OGTT with glucose & insulin measurements at 0, 1 and 2 hours. During the 22-year follow-up, 164 men out of 970 had a major CHD event (CHD death or nonfatal myocardial infarction). The results showed that elevated plasma insulin levels during OGTT, expressed as AUC insulin, were associated with an increased risk of a major CHD event (CHD death or nonfatal MI). This association was largely independent of other CV risk factors, including blood glucose, cholesterol, triglycerides, blood pressure, indexes of obesity and its distribution, smoking, and physical activity. The predictive power of AUC insulin, however, decreased with lengthening follow-up time. Nevertheless, over 22 years of follow-up, the predictive power of AUC insulin was of the same magnitude as that of cholesterol when these variables were entered as continuous variables into multivariate analyses. This is fantastic!
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