Impaired fasting glucose (IFG) is highly prevalent in the elderly, yet its relationship to health and outcomes is unclear in this age group. This study examined whether IFG in the elderly was associated with a greater burden of metabolic and inflammatory abnormalities and disease burden and greater 2-year mortality and incident diseases.
Research design and methods:
A prospective observational study of a population-derived, community-dwelling cohort (n=945, mean age 78.6±4.7), recruited from the electoral roll, described elsewhere.1 Disease ascertainment was by standardized questionnaire at baseline and at 2-years. Fasting blood was collected and glucose, metabolic and inflammatory markers measured. Disease prevalence, cardiovascular risk, markers of inflammation and oxidative metabolism, 2-year mortality rate and 2-year incident disease were compared in IFG vs. normal fasting glucose (NFG), adjusting for covariates of age, sex, smoking, hypertension and body mass index.
IFG prevalence was 41% at baseline. Rates of heart disease, stroke, kidney disease or any cancer were similar between IFG and NFG. IFG was associated with higher levels of inflammatory markers and end-products of oxidative metabolism, including interleukin-8 (21.8 vs. 18.6 pg/ml, p<0.01), interleukin-12p70 (3.64 vs 3.40 pg/ml, p<0.05) urate (0.35 vs. 0.32 mmol/l, p<0.001) and malondialdehyde (13.4 vs. 12.8 umol/l, p<0.001), compared to NFG.
At 2-years, incident rates of cardiac disease, stroke and cancers were similar in IFG compared to NFG, as was 2-year all-cause mortality.
IFG in the elderly was accompanied by increased metabolic and inflammatory markers, but not associated with increased 2-year incident disease burden or 2-year mortality. Longer term prospective studies will further clarify whether IFG-associated abnormalities in the elderly portend greater eventual morbidity and mortality.