Associations of the Gap Between 2-Hour Post-Load Plasma Glucose and Fasting Blood Glucose With All-Cause or Cardiovascular Mortality in US Normoglycemic Adults.

Background: The gap between 2-hour post-load plasma glucose (2 h PG) and fasting blood glucose (FBG) has been shown to be informative of the risk of developing prediabetes and diabetes. We aimed to examine the significance of the gap between 2 h PG and FBG in relation to all-cause or cardiovascular disease (CVD) mortality in normoglycemic adults.

Methods: 3611 normoglycemic participants from the 2005-2016 US National Health and Nutrition Examination Survey were included and dichotomized into the low (2 h PG ≤ FBG) and high post-load (2 h PG > FBG) groups. Associations of the gap between 2 h PG and FBG with all-cause or CVD mortality were evaluated with Kaplan-Meier curves, Cox proportional hazard ratio, and subgroup analysis.

Results: The mean age was 38.80 years, with a male prevalence of 43.59%. Finally, 1746 (50.22%) and 1865 (49.78%) participants were categorized into the low and high post-load groups, respectively. During a median follow-up of 107 months, 130 deaths (36 CVD-related) occurred. Kaplan-Meier curves showed significantly higher all-cause and CVD mortality rates in the high post-load group compared with the low post-load group. The hazard ratio and 95% confidence interval for all-cause and CVD mortality in the high post-load group were 1.816 (1.149-2.870) and 2.302 (1.052-5.038), respectively, with the low post-load group as the reference. The results were robust and consistent in the sensitivity and subgroup analyses.

Conclusion: The gap between 2 h PG and FBG may be potentially useful for predicting the risk of all-cause and CVD mortality in US normoglycemic adults.