Objective  To explore the association of fasting plasma glucose (FPG) and two hour post-load plasma glucose (2hPG) with cardiovascular diseases (CVD) among adults with normal glucose tolerance (NGT) and to provide evidences for prevention and control of risk factors of CVD in China.

  Methods  We randomly selected 4 307 permanent residents aged 35 – 74 years and with normal FPG (< 6.1 mmol/L) and 2hPG (<7.8 mmol/L) in 3 urban districts and 3 villages in Qingdao municipality. Multivariate adjusted odds ratio (ORs) and its 95% confidence interval (95% CI) for incidence of CVD were estimated for individuals with 2hPG > FPG as compared with those with 2hPG≤FPG, controlling for underlying confounders.

  Results  Of all the participants, 1 815 were identified with CVD. The prevalence of CVD was significantly higher in the participants with 2hPG > FPG than in those with 2hPG≤FPG (42.4% vs. 36.2%)(P < 0.01). Compared with those with 2hPG≤FPG, the participants with 2hPG > FPG were at older age and had higher body mass index, diastolic blood pressure, total cholesterol, triglycerides, and insulin secretion (P < 0.01 for all). Multivariate logistic regression analysis demonstrated that the participants with following characteristics were at a higher risk of CVD: 2hPG > FPG (OR = 1.210, 95% CI: 1.042 – 1.405), elder age (OR = 1.073, 95% CI: 1.064 – 1.082), high body mass index (OR = 1.170, 95% CI: 1.144 – 1.196), high triglyceride (OR = 1.396, 95% CI: 1.127 – 1.729), and alcohol drinking (1.269, 95% CI: 1.154 – 1.396). Stratified analysis revealed that for the female participants aged < 60 years and FPG < 5.6 mmol/L, those with 2hPG > FPG were at a higher risk of CVD compared to those with 2hPG≤FPG. The risk of CVD was attenuated among the participants with 2hPG > FPG after adjusting for vegetable and fruit consumption, insulin resistance, and insulin secretion.

  Conclusion  The elevated 2hPG is associated significantly with increased risk of CVD among community adults with normal glucose tolerance.