Abstract
The study was conducted to investigate the relationship between glucose concentration and cerebrovascular lesions in nondiabetic elderly subjects. Subjects who had a diabetic history or an FPG≥140mg/dl were excluded. We analyzed a total of 482 cases. All of the subjects were residents of the Yokufukai Home for the aged, had undergone a 50-g OGTT prior to death and had been autopsied. The subjects were divided into quintiles based on 2h glucose concentration. Among subjects who had been under 75 years of age at the time of the OGTT, the incidence of cerebral infarction with neurologic disability was significantly lower in the first quintile than in the other four. There were no significant differences among the five quintile groups in incidence of minor infarctions or in severity of cerebral athero-sclerosis. Among subjects 75 or over at the time of OGTT, there were no significant differences among the five quintile groups either in incidence of cerebral infarction or in severity of cerebral atherosclerosis. Our results demonstrate an apparent nonlinear relationship between glucose concentration and cerebral infarction, with an increase of cerebral infarction with neurologic disability occurring in subjects above the 80th percentile for post-challenge glucose. Our results also suggest that mild glucose intolerance in nondiabetic elderly subjects in their mid-seventies and above does not significantly affect the development of cerebrovascular lesions.
