Fasting plasma glucose trajectories are associated with ischemic stroke in the elderly: a longitudinal study using group-based trajectory modeling in Chinese communities.

BACKGROUND

Ischemic stroke (IS) has emerged as a severe health concern, particularly among the elderly. Although baseline fasting plasma glucose (FPG) has been linked to IS, research on the relationship between longitudinal FPG and IS risk is scarce. We aimed to investigate the association between FPG trajectories and IS incidence among the elderly using group-based trajectory modeling (GBTM).

METHODS

This longitudinal study in China enrolled 9,426 elderly individuals aged 65 and above, who had participated in health check-ups from 2017 to 2022. Employing a multivariable Cox proportional hazards regression model, we investigated the link between baseline FPG and IS incidence. GBTM was used to identify FPG trajectory patterns from the longitudinal data, which were then correlated with IS risk through further multivariable Cox regression analysis. We also performed stratified analyses and sensitivity analyses to explore these associations.

RESULTS

Diabetes FPG level in elderly individuals was significantly associated with an increased risk of IS at baseline, as indicated by both WHO criteria and ADA criteria. Longitudinal analysis revealed that individuals in the moderate increasing group and high stable group had 1.28 times (HR = 1.28, 95% CI 1.01‒1.62, P < 0.05) and 1.60 times (HR = 1.60, 95% CI 1.20‒2.15, P < 0.05) higher risks of IS, respectively, compared to the low stable group.

CONCLUSIONS

Regular health screenings should emphasize monitoring FPG trends among the elderly to aid in IS prevention. Public health efforts targeting impaired fasting glucose control may reduce the risk of IS.