@article {1530,
	title = {Utility of 2-Hour Postchallenge Glucose in Predicting Incident Diabetes in Older Adults with Normal Fastng Glucose: 9-Year Follow-up of the Cardiovascular Health Study.},
	journal = {JCOM},
	volume = {12},
	year = {2005},
	month = {2005-02-01},
	pages = {87},
	chapter = {83},
	abstract = {	

S.80 (PUBLISHED) Utility of 2-Hour Postchallenge Glucose in Predicting Incident Diabetes in Older Adults with Normal Fastng Glucose: 9-Year Follow-up of the Cardiovascular Health Study. Doug Shaffer
Writing Chair

CHS Collaborator
Proposal Status

PUB: (Diab.Med) 2-05; vol 12 no. 2 83-87
Writing Group

Doug Shaffer, Nicholas Smith, Joshua Barzilay,Peter Savage, Lewis Kuller, Gregory Burke
Keywords

Description

ABSTRACT

Objective

We calculated rates of diabetes mellitus (DM, defined as having a fasting glucose (FG) > 126 mg/dl or starting diabetic medication) in older adults > 65 years of age (mean 72.9 years, SD=5.6) with normal FG and evaluated the added value of baseline 2-hour glucose (2HG) level as a predictor of subsequent DM.

Methods

We evaluated 3563 participants in the Cardiovascular Health Study with normal FG

(< 110 mg/dl) and calculated DM incidence rates overall and stratified by baseline 2HG using 3 World Health Organization categories (< 140 [normal], 140-199 [impaired glucose tolerance], and > 200 mg/dl [DM]).

Results

Ninety-five participants (2.7\%) developed DM during a mean follow-up of 8.5 years (median follow-up 9.9 years) corresponding to an overall incidence rate of 3.1 cases per 1000 person-years. The DM incidence rates given baseline 2HG category were 1.7 (< 140 mg/dl), 4.4 (140-199 mg/dl), and 13.1 (> 200 mg/dl) per 1000 person-years, respectively. Individuals with baseline 2HG concentrations of 140-199 mg/dl and > 200 mg/dl were 2.7 times (HR=2.7, 95\% CI 1.7, 4.2) and 7.8 times (HR=7.8, 95\% CI 4.2, 13.3) more likely to develop DM compared to those with baseline 2HG measure < 140 mg/dl, respectively. These risks changed little after adjusting for baseline FG, age, sex, race, and BMI: HR=2.3 (1.4, 3.8) and HR=7.5 (4.3, 13.1), respectively.

Conclusions

While 2HG is predictive of DM, the overall DM rate in older adults with normal FG is low. FG without 2HG may be adequate for DM screening in this population.},
	keywords = {Adult, Diabetes, Glucose, Health},
	author = {Shaffer, DN and Smith, NL and Barzilay, JI and Savage, PJ and Kuller, LK and Burke, GL}
}
@article {7803,
	title = {The associations of subclinical atherosclerotic cardiovascular disease with hip fracture risk and bone mineral density in elderly adults.},
	journal = {Osteoporos Int},
	volume = {29},
	year = {2018},
	month = {08/2018},
	pages = {2230},
	chapter = {2219},
	abstract = {In the absence of clinically recognized cardiovascular disease, increased carotid artery intimal medial thickness was associated with higher hip fracture risk in older adults, despite its association with higher bone mineral density (BMD). Low ankle brachial index and aortic wall thickness were not associated with fracture risk or BMD.
INTRODUCTION:

Clinically recognized cardiovascular disease (CVD) is associated with osteoporosis and hip fracture risk, but the relationship of subclinical atherosclerosis to bone health is not certain.
METHODS:

We followed 3385 participants from the Cardiovascular Health Study (mean age 74.7 {\textpm} 5.3 years) with a median time to fracture of 12.1 years who underwent baseline carotid artery and aortic wall ultrasound scanning and ankle brachial blood pressure index (ABI) determinations. A subset underwent bone mineral density (BMD) testing.
RESULTS:

There were 494 hip fractures during follow-up. Among persons without clinical CVD, an average standard-deviation increase in a composite score of maximal common and internal carotid artery intimal medial thickness (cIMT) was associated with increased risk of hip fracture [(HR 1.18 [1.04, 1.35]), even though cIMT was positively associated with BMD. Neither aortic wall thickness nor ABI were associated with hip fracture risk or BMD. Among participants with clinical CVD, cIMT and aortic wall thickness, but not ABI, were associated with increased hip fracture risk.
CONCLUSION:

Subclinical cIMT is associated with an increased risk of hip fractures despite being associated with increased BMD. This finding suggests that vascular health, even in its early stages, is linked to bone health, by pathways other than BMD.},
	keywords = {Bone mineral density, Hip fracture, Risk, Subclinical atherosclerosis},
	doi = {10.1007/s00198-018-4611-9},
	url = {https://www.ncbi.nlm.nih.gov/pubmed/30132027},
	author = {Barzilay, JI and B{\r u}zkov{\'a}, Petra and Cauley, J A and Robbins, J. A. and Fink, Howard A and Mukamal, K J}
}
