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American Journal of Epidemiology Vol. 149, No. 5: 471-475
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health
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Association between Serum Fructosamine and Mortality in Elderly Women
The Study of Osteoporotic Fractures
1General Internal Medicine Section, Department of Veterans Affairs Medical Center San Francisco, CA
2Department of Medicine, University of California San Francisco, CA
3Department of Epidemiology and Biostatistics, University of California San Francisco, CA
4Division of General Internal Medicine, Department of Medicine, University of California San Francisco, CA
Reprint requests to Dr. Warren S. Browner, General Internal Medicine 111A1, Department of Veterans Affairs Medical Center, San Francisco, CA 94121.
Serum fructosamine levels can be used to estimate long-term serum glucose values and can be measured in frozen serum. The authors examined whether fructosamine levels were associated with mortality in a cohort of 9, 704 white women (>65 years of age) recruited from September 1986 to October 1988 at four clinical centers in the United States. A random sample of women who had died during a mean of 6 years of follow-up (n = 55) was compared with randomly selected controls (n = 276, 54 of whom had died). Fructosamine assays were performed blinded to vital status. Hazard ratios with 95% confidence intervals were adjusted for age, clinical center, smoking, hypertension, and serum albumin and cholesterol levels. Each standard deviation (46 u.mol) increase in fructosamine level was associated with a 1.3-fold (95% confidence interval (Cl) 1.0–1.6, p = 0.04) increased rate of all-cause mortality, including a 1.5-fold (95% Cl 1.0–2.1, p = 0.03) increase in cardiovascular disease mortality. Elevated fructosamine levels (>285 umol/liter) were associated with a 4.3-fold (95% Cl 1.6–12, p = 0.004) increased rate of cardiovascular mortality; in women without a history of diabetes, the hazard ratio was 4.6 (95% Cl 1.3–16, p = 0.02). Fructosamine level, or another indicator of glycemia, should be included when the risk of cardiovascular disease among older patients is evaluated. Am J Epidemiol 1999; 149:471–5.
cardiovascular diseases; coronary disease; diabetes mellitus; fructosamine; mortality; risk factors
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