Skip to main content
SpringerLink
Log in

Impaired glucose tolerance and its co-variates among 2079 non-diabetic elderly subjects

Ten-year mortality and morbidity in the CASTEL study

  • Original
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

Abstract

This study evaluated the role of impaired glucose tolerance (IGT) as a risk factor in a general population of 2079 non-diabetic elderly subjects. The 10-year cardiovascular morbidity was similar in normal and IGT subjects. Mortality was greater in IGT, but the Cox equations of the hazard rate were different in younger and older subjects: age, sex, lung function (forced expiratory volume in 1 s, FEV1), serum uric acid, IGT and proteinuria were predictors of overall mortality in the age class 65–79 years, while only the first 4 were associated with cardiovascular mortality. The same four items also predicted overall survival in subjects over 79 years old, while only age and uric acid were predictors of cardiovascular mortality. In older subjects, total cholesterol showed an inverse predictive value. Hyperuricaemia (>6.4 mg/dl) and proteinuria did predict mortality in normal but not in IGT subjects, while reduced FEV1 (<60% theoretical) was predictive in all. In 65–79-year-old subjects IGT predicted mortality provided that FEV1 was normal, while in those 380 years old IGT was not a predictor. These interrelationships should be taken into account to better understand the factors underlying mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. National Center for Health Statistics, The National Health Interview Survey design 1973–84 and procedures 1975–83. NCHS Vital and Health Statistics Series 1 (No. 18) US Department of Health and Human Services, Washington DC, 1985

    Google Scholar 

  2. Hiltunen L, Luukinen H, Koshi K, Kivelä SL, Prevalence of diabetes mellitus in an elderly Finnish population. Diabetic Med 11:41–49, 1994

    Google Scholar 

  3. WHO Scientific Group on the Epidemiology of Aging, The uses of epidemiology in the study of the elderly. (WHO Tech Rep Series), WHO, Geneva, 1984

    Google Scholar 

  4. Cornoni-Huntley, J, Brock DB, Ostifield AM, Taylor JO, Wallace RB, Established populations for epidemiologic studies of the elderly. Resource data book. (NIH Publ 86-2443) National Institute on Aging, 1986

  5. Australian Bureau of Statistics, The Disability and Ageing Survey. Aust Govt Publ Serv, Camberra, 1989

    Google Scholar 

  6. 6.Aronow WS, Cardiac risk factors: still important in the elderly. Geriatrics 45:71–80, 1980

    Google Scholar 

  7. Aronow WS, Starling L, Etienne F, D'Alba P, Edwards M, Lee NH, Parungao RF, Risk factors for coronary artery disease in persons older than 62 years in a long-term health care facility. A J Cardiol 57:18–20, 1986

    Google Scholar 

  8. Simons LA, Friedlander Y, McCallum J, Simon J, Powell L, Heller R, Berry G, The Dubbo Study of the health of elderly: correlates of coronary heart disease at study entry. J Am Geriatr Soc 39:584–590, 1991

    Google Scholar 

  9. Kannel WB, Vokonas PS, Primary risk factors for coronary heart disease in the elderly: the Framingham Study. In: Wenger NK, Furberg CD, Pitt E (eds) Coronary heart disease in the elderly. Elsevier, New York, pp 60–92, 1986

    Google Scholar 

  10. Stengård JH, Tuomiletho J, Pekkanen J, Kivinen P, Kaarsalo E, Nissinen A, Karvonen MJ, Diabetes mellitus, impaired glucose tolerance and mortality among elderly men: the finnish cohorts of the Seven Countries Study. Diabetologia 35:760–765, 1992

    Google Scholar 

  11. Maggi S, Bush TL, Hale WE, Diabetes mellitus and other cardiovascular risk factors in an elderly population. Age Ageing 19:173–178, 1990

    Google Scholar 

  12. Kannel WB, Larson M, Long-term epidemiologic prediction of coronary disease. The Framingham experience. Cardiology 82:137–152, 1993

    Google Scholar 

  13. Kannel WB, McGee DL, Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham study. Diabetes Care 2:120–126, 1979

    Google Scholar 

  14. Casiglia E, Spolaore P, Mormino P, Maschio O, Colangeli G, Celegon L, Maggiolo G, Tittoto L, Pasinato A, Ambrosio GB, The CASTEL project (CArdiovascular STudy in the ELderly): protocol, study design and preliminary results of the initial screening. Cardiologia 36:569–576, 1991

    Google Scholar 

  15. Casiglia E, Spolaore P, Ginocchio G, Ambrosio GB, Unexpected effects of coffee consumption on liver enzymes. Eur J Epidemiol 9:23–27, 1993

    Google Scholar 

  16. Casiglia E, Ginocchio G, Spolaore P, Marchioro M, Di Menza G, Gozzetti S, Ambrosio GB, Only uric acid and FEV1 are predictors of mortality in very old subjects. Acta Cardiol 48:290–292, 1993

    Google Scholar 

  17. Casiglia E, Spolaore P, Mazza A, Ginocchio G, Colangeli G, Onesto C, Di Menza G, Pegoraro L, Ambrosio GB, Effects of two different therapeutic approaches on total and cardiovascular mortality in the Cardiovascular Study in the ELderly (CAS-TEL). Jpn Heart J 35:589–600, 1994

    Google Scholar 

  18. Casiglia E, Spolaore P, Ginocchio G, Marchioro M, Mazza A, Di Menza G, Maniati G, Daskalakis C, Colangeli G, Ambrosio GB, Mortality in relation to Minnesota Code items in elderly subjects. Sex-related differences in the CArdiovascular STudy in the ELderly (CASTEL). Jpn Heart J 34:567–577, 1993

    Google Scholar 

  19. Casiglia E, Spolaore P, Ginocchio G, Colangeli G, Di Menza G, Marchioro M, Mazza A, Ambrosio GB Mortality in very old subjects aged 80 years or over. The CASTEL (CArdiovascular STudy in the ELderly) Eur J Epidemiol 9:577–586, 1993

    Google Scholar 

  20. Pauletto P, Casiglia E, Pessina AC, Do plasma lipids have any relation to cardiovascular disease in the elderly? High BP 1:121–125, 1992

    Google Scholar 

  21. Editorial, Type-2 diabetes or NIDDM: looking for a better name. Lancet 1:589–591, 1989

  22. West KM, Standardization of definition, classification, and reporting in diabetes-related epidemiologic studies. Diabetes Care 2:65–76, 1979

    Google Scholar 

  23. Other-Nielsen O, Faber O, Sörensen NS, Beck-Nielsen H, Classification of newly diagnosed diabetic patients as insulin-requiring or non-insulin-requiring based on clinical and biochemical variables. Diabetes Care 11:531–537, 1988

    Google Scholar 

  24. Wen SW, Kramer MS, Hoey J, Hanley JA, Usher RH, Terminal digit preference, random error, and routine bias in routine clinical measurement of blood pressure. J Clin Epidemiol 46:1187–1193, 1993

    Google Scholar 

  25. Mancia G, Bertinieri G, Grassi G, Parati G, Pomidossi G, Ferrari A, Gregorini L, Zanchetti A, Effects of blood pressure measurement by the doctor on patient's blood pressure and heart rate. Lancet 2:695–697, 1983

    Google Scholar 

  26. Guidelines for the Management of Mild Hypertension: Memorandum from a WHO/ISH Meeting. ISH Hypertension News, Special Edition:3–16, 1993

  27. WHO Expert Committee, Arterial hypertension. (Technical Report Series no. 628) WHO, Geneya, 1978

    Google Scholar 

  28. Cherniack RM, Raber MB, Normal standards for ventilatory function using an automated wedge spirometer. Am Rev Resp Dis 106:38–46, 1972

    Google Scholar 

  29. Rose GA, Blackburn H, Gillum RF, Prineas RJ, Cardiovascular survey methods. WHO, Geneva, 1982

    Google Scholar 

  30. Mikkanen L, Laasko M, Pyörälä K, Asymptomatic hyperglycemia and atherosclerotic vascular disease in the elderly. Diabetes Care 15:1020–1230, 1993

    Google Scholar 

  31. Chan JCN, Cheung CK, Swaminathan R, Nicholls MG, Cocram CS, Obesity, albuminuria and hypertension among Hong Kong Chinese with non-insulin-dependent diabetes melitus. Postgrad Med J 69:204–210, 1993

    Google Scholar 

  32. Kaplan N, Microalbuminuria: a risk factor for vascular and renal complication of hypertension. Am J Med 92 (Suppl. 4B): 8–12, 1992

    Google Scholar 

  33. Cochran WG, Experimental designs. Wiley, New York, 1957

    Google Scholar 

  34. Snedecor GW, Cochran WG, Statistical methods. Iowa University Press, Ames, 1980

    Google Scholar 

  35. Kleinbaum DG, Kupper LL, Analysis of covariance and other methods for adjusting continuous data. Applied regression analysis and other multivariable methods. Duxbury Press, Boston, 1980

    Google Scholar 

  36. Huitema BE, The analysis of covariance and alternatives. Wiley, New York, 1980

    Google Scholar 

  37. Dixon WJ, BMDP Statistical software manual. Bio-Medical Data Processing Statistical Software Inc. University of California Press, Princeton Fulfillment Services, Princeton, 1992

    Google Scholar 

  38. Bishop YMN, Frienderg SE, Hollond PW, Discrete multivariate analysis: theory and practice. MIT Press, Cambridge, Mass., 1975

    Google Scholar 

  39. Cox DR, Oakes O, Analysis of survival data. Chapman and Hall, London, 1984

    Google Scholar 

  40. Cutler SJ, Ederer F, Maximum utilisation of the life-table method in analysing survival. J Chronic Dis 8:699–713, 1958

    Google Scholar 

  41. Chaing CL, Standard error of the age-adjusted death rate. Vital Statistics — Special Reports 47:275–285, 1961

    Google Scholar 

  42. Mantel N, Evaluation of survival data and two rank order statistics arising in its consideration. Cancer Chemother Rep 50:163–170, 1966

    Google Scholar 

  43. Mausner JS, Bahn AK, Epidemiology. An introductory text, App. 7-1. Adjustment of rates. Saunders, Philadelphia, 1974

    Google Scholar 

  44. Cox DR, Regression models and life tables. J R Stat Soc 34b:187–220, 1972

    Google Scholar 

  45. Casiglia E, Spolaore P, Ginocchio G, Colangeli G, Maschio O, Marchioro M, Lanzieri M, Ambrosio GB, Proteinuria predicts mortality among elderly but not among very old subjects. J Nephrol 5:89–93, 1993

    Google Scholar 

  46. Pessina AC, Casiglia E, Pal Palù C, Mortality in the elderly is independent of blood pressure. Can J Cardiol 11 (Suppl D):44, 1995

    Google Scholar 

  47. Casiglia E, Daskalakis C, Maniati G, Onesto C, Tramontin P, Biasin R, Capuani M, Cerutti A, Di Menza G, Pessina AC, Left ventricular hypertrophy is not a predictor of mortality in the elderly. High BP (in press, March 1997)

  48. Davvey GD, Shipley MJ, Matmot MG, Rose G, Plasma cholesterol concentration and mortality. The Whitehall Study. JAMA 267:70–76, 1992

    Google Scholar 

  49. Krumholz HM, Seeman TE, Merril SS, Mendes de Leon CF, Vaccarino V, Silverman DL, Tsukahara R, Ostfeld AM, Berkman LF, Lack of association between cholesterol and coronary heart disease mortality and morbidity and all-cause mortality in persons older than 70 years. JAMA 272: 1335–1340, 1994

    Google Scholar 

  50. Campbell J, Busby W, Robertson MC, Over 80 years and no evidence of coronary disease: characteristics of a survivor group. J Am Geriatr Soc 41:1333–1338, 1993

    Google Scholar 

  51. Damsgaard EM, Froland A, Jorgensen OD, Mogensen CE, Prognostic value of urinary albumin excretion rate and other risk factors in elderly diabetic patients and non-diabetic control subjects surviving the first 5 years after assessment. Diabetologia 36: 1030–1036, 1993

    Google Scholar 

  52. Mogensen CE, Damsgaard EM, Froland A, Nielsen S, De Fine Olivares N, Schmitz A, Microalnuminuria in non-insulin-dependent diabetes. Clin Nephrol 38 (Supll 1):28–38, 1992

    Google Scholar 

  53. Saad MF, Knowler WC, Pettitt DJ, Nelson RG, Mott DM, Bennett PH, Sequential changes in serum insulin concentration during development of non-insulin dependent diabetes. Lancet 1:1356–1359, 1989

    Google Scholar 

  54. Croxson SCM, Price DE, Burden M, Jagger C, Burden AC, The mortality of elderly people with diabetes. Diabetic Med 11: 250–252, 1994

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine I, University of Padova, Via Giustiniani 2, I-35128, Padova, Italy

    E. Casiglia, P. Pauletto, A. Mazza, G. Ginocchio, G. di Menza, L. Pavan, P. Tramontin, M. Capuani & A. C. Pessina

Authors
  1. E. Casiglia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Pauletto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Mazza
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Ginocchio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. di Menza
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Pavan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P. Tramontin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. Capuani
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. A. C. Pessina
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Casiglia, E., Pauletto, P., Mazza, A. et al. Impaired glucose tolerance and its co-variates among 2079 non-diabetic elderly subjects. Acta Diabetol 33, 284–290 (1996). https://doi.org/10.1007/BF00571566

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00571566

Key words

Search

Navigation