Mortality prediction in the elderly by an easily measured metabolic index

Diab Vasc Dis Res. 2012 Jul;9(3):226-33. doi: 10.1177/1479164111434317. Epub 2012 Jan 25.

Abstract

Objective: Hyperglycaemia enhances the risk of cardiovascular events and death, while high-density lipoprotein cholesterol (HDLc) is protective. Information on these associations among the elderly population is scanty. We applied a cardiometabolic risk index (CMRI) based on HDLc and fasting plasma glucose (FPG) in an elderly Swedish population.

Methods: In total, 432 75-year-olds were followed for 10-year mortality. The impact of risk factors on survival was analysed using Cox regression.

Results: HDLc (mmol/l; median and interquartile range) was 1.6 (1.3-2.0) in women and 1.4 (1.2-1.5) in men, while FPG was 5.9 (5.5-6.6) and 5.9 (5.5-6.5). Some 89 persons were at high risk according to CMRI, and 163 persons died. FPG was related to mortality in women (HR; 95% CI: 1.23; 1.10-1.37) and there was a similar trend in men (1.08; 1.00-1.17; p = 0.061). Increasing HDLc was protective in men (0.38; 0.19-0.77) but not in women (0.77; 0.45-1.29). CMRI was related to mortality in both genders even after adjustment for established risk factors (1.79; 1.14-2.79; p = 0.011).

Conclusions: The CMRI helps identify elderly subjects at risk and may serve as a cost-effective risk prediction tool.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Blood Glucose / analysis*
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / mortality*
  • Cholesterol, HDL / blood*
  • Female
  • Humans
  • Hyperglycemia / epidemiology
  • Longitudinal Studies
  • Male
  • Risk Factors
  • Sex Factors
  • Survival Rate*
  • Sweden / epidemiology

Substances

  • Biomarkers
  • Blood Glucose
  • Cholesterol, HDL