[Diabetes family history is associated with early insulin response, in healthy Hispanic-Mexican subjects].
Guerrero-Romero F,Rodríguez-Morán M
Gaceta medica de Mexico
OBJECTIVE:To identify the associated risk factors to the increase of early insulin response in healthy Hispanic-Mexican subjects. METHODS:Comparative cross-sectional study including 130 nonpregnant women and 54 men older than 30 years of age, randomly selected from Durango City, an urban population from the North of Mexico. According to the insulinogenic index value that assesses the early insulin response, subjects were distributed into quartiles. Subjects with increased insulin response (4th quartile) were compared against a control group (2nd and 3rd quartile). RESULTS:There were no significant differences by obesity (body mass index 29.2 +/- 5.1 vs. 28.7 +/- 4.5 kg/m2), nor fasting nor 2-h post dose glucose (85.2 +/- 16.1 vs 82.1 +/- 10.4 mg/dL, and 95. +/- 25.5 vs. 99.1 +/- 23.1 mg/dL) between subjects in the 4th quartile vs. subjects in the 2nd and 3rd quartile, respectively. The family history of diabetes (FHD) (Odds ratio 3.9; C1(95%) 1.3-9.1, p < 0.01) was a powerful risk factor associated to increased early insulin response. CONCLUSIONS:FHD is an independent predictor for increased early insulin response in Hispanic-Mexican subjects.
Characterisation of subjects with early abnormalities of glucose tolerance in the Stockholm Diabetes Prevention Programme: the impact of sex and type 2 diabetes heredity.
Kuhl J,Hilding A,Ostenson C G,Grill V,Efendic S,Båvenholm P
AIMS/HYPOTHESIS:We evaluated the impact of sex and type 2 diabetes heredity on the prevalence and pathogenesis of early abnormalities of glucose homeostasis in subjects participating in the Stockholm Diabetes Prevention Programme. METHODS:A sample of 3,128 men and 4,821 women, of whom approximately half had a family history of type 2 diabetes (FHD) was categorised according to an OGTT: NGT, IFG, IGT, combined glucose intolerance and type 2 diabetes. The homeostasis model assessment was used to determine insulin sensitivity and beta cell function. RESULTS:Prevalence of early abnormalities of glucose metabolism was two to three times higher in subjects with FHD and two to three times higher in men compared to women. Both maternal and paternal heredity of type 2 diabetes were associated with an increased risk of having early abnormalities of glucose metabolism. However, in women with type 2 diabetes heredity on the father's side seems to have less impact on an increased risk of having type 2 diabetes. Both waist circumference and systolic blood pressure were increased in subjects with abnormalities of glucose homeostasis, whereas insulin sensitivity and beta cell function were decreased. Subjects with IFG had more pronounced impairment of beta cell function and insulin sensitivity than subjects with IGT. CONCLUSION/INTERPRETATION:An FHD and male sex increased the prevalence of abnormalities of glucose homeostasis. Subjects with IFG had more pronounced defects of insulin secretion and action than subjects with IGT.
Family history of diabetes, parental body mass index predict obesity in Latino children.
Villa-Caballero Leonel,Arredondo Elva Maria,Campbell Nadia,Elder John P
The Diabetes educator
PURPOSE:The purpose of this study is to examine the association between family history of diabetes (FHD), body mass index (BMI), and acculturation with children's BMI status. METHODS:Baseline data from a randomized community intervention trial promoting healthy eating and physical activity were collected in children living in San Diego, California. A self-administered survey was completed by primary caregivers at each school assessing maternal diabetes, BMI, acculturation, and socioeconomic status (SES). Anthropometric data (height, weight, and BMI) from mothers and children were also collected. RESULTS:A total of 812 caregivers completed the baseline survey. Adjusting for maternal age, marital status, and socioeconomic level, women who had been diagnosed with diabetes or gestational diabetes or who received diabetes treatment were significantly more likely to have overweight children. Maternal BMI was also associated with children's weight. Maternal acculturation level was marginally associated with children's BMI. CONCLUSIONS:FHD, gestational diabetes, and BMI were associated with children's overweight status. More comprehensive interventions are needed to prevent obesity in Latino children and adults.
Prevalence of impaired fasting glucose and analysis of risk factors in Han adolescents.
Lu Qiang,Yin Fu-Zai,Ma Chun-Ming,Liu Bo-Wei,Lou Dong-Hui,Wang Rui,Wu Guang-Fei,Han Gai-Ling,Shen Yi,Liu Bo,Qin Chun-Mei
Journal of diabetes and its complications
OBJECTIVE:To evaluate the prevalence of impaired fasting glucose (IFG) and its relationship with cardiovascular risk factors in Han adolescents aged 13 to 18 years. METHODS:Step 1: A cross-sectional study was conducted on 3937 Han adolescents. IFG was defined as a fasting glucose of 5.6 to 7.0 mmol/l. Measurements included anthropometric measurements, fasting plasma glucose (FPG), and serum lipids. Step 2: We identified 60 adolescents with IFG from the IFG group using a random number table, and 60 adolescents with normal fasting glucose (NFG) were matched for age and gender with the random IFG sample. Serum true insulin (TI) was further measured. RESULTS:(1) The prevalence of IFG was 3.5% and was similar in boys and girls (3.9% vs. 3.1%, P=.177). The prevalence of IFG in adolescents with a family history of type 2 diabetes (FHD) was higher than in adolescents without FHD (6.3% vs. 2.5%, P=.000). (2) In logistic regression, the clustering of cardiovascular risk factors among adolescents with IFG was 1.889 (95% CI: 1.125-3.171, P=.016) times compared with adolescents with NFG adjusted by age and gender. (3) Multiple linear regression analysis using FPG as the dependent variable showed that waist circumference (beta=0.003, P=.000) was a significant independent predictor. (4) In Step 2, the IFG group showed significantly higher levels of lnTI and lnHOMA-IR than the NFG group (P<.01). FPG was a significant independent predictor for lnTI (beta=0.478, P=.000) and lnHOMA-IR (beta=0.671, P=.000). CONCLUSION:We found a high prevalence of IFG in Han adolescents. Genetic susceptibility and abdominal obesity were the main factors causing adolescent IFG. Adolescents with IFG increased the clustering of cardiovascular risk factors.
Influence of ethnicity and familial diabetes on glucose tolerance and insulin action: a physiological analysis.
Ferrannini Ele,Gastaldelli Amalia,Matsuda Masafumi,Miyazaki Yoshinori,Pettiti Maura,Glass Leonard,DeFronzo Ralph A
The Journal of clinical endocrinology and metabolism
Both ethnicity and familial diabetes (FHD) confer risk for type 2 diabetes [diabetes mellitus (DM)], but their relative influence has not been established. To analyze the separate impact of ethnicity, Mexican-American vs. Caucasian, and FHD on the physiological determinants of glucose tolerance, we measured insulin sensitivity of glucose uptake (IS(GU)) (by the clamp technique), endogenous glucose production (by 3-[(3)H]glucose infusion), and insulin secretory response (to oral glucose) in 172 Mexican-Americans and 60 Caucasians with normal glucose tolerance (NGT) or DM. IS(GU) was markedly reduced in diabetics vs. NGT (3.9 +/- 0.2 vs. 8.4 +/- 0.5 ml.min(-1).kg(ffm)(-1), P < 0.0001), and lower in Mexican-Americans than in Caucasians (5.3 +/- 0.3 vs. 7.3 +/- 0.7 ml.min(-1).kg(ffm)(-1), P < 0.003; ffm, fat-free mass). In a multivariate analysis including both ethnicity and FHD (and adjusting for body mass index, age, and diabetes), ethnicity was still a significant (P = 0.02) independent correlate of IS(GU). Insulin resistance of glucose production was increased in diabetics (14 +/- 1 mmol.min(-1).[ micro U/ml], P < 0.0001 vs. 9 +/- 1 of NGT), whereas the 30' insulin/glucose ratio was decreased (16 +/- 1 micro U/mg, P < 0.0001 vs. 60 +/- 5). In multivariate models, neither ethnicity nor FHD were significant independent correlates of glucose production and early insulin response. We conclude that the primary physiological target of the propensity to diabetes of Mexican-Americans is insulin resistance of glucose uptake.
Five-year predictive factors of type 2 diabetes in men with impaired fasting glucose.
Lecomte P,Vol S,Cacès E,Born C,Chabrolle C,Lasfargues G,Halimi J-M,Tichet J
Diabetes & metabolism
AIM:The outcome of 743 French men (age 20-60) with impaired fasting glucose (IFG) [blood glucose 6.1-6.9 mmol/l] at T1 was evaluated 5 years later, at T2. METHODS:Personal and family medical history, smoking, nutritional habits, physical activity, blood pressure, body mass index (BMI) and waist girth, fasting biological data were collected at T1 and T2. Predictive factors for developing diabetes were compared between those who returned to normal fasting glucose and those who had diabetes, before and after adjustment for age, BMI, glucose and triglyceride (TG) levels. RESULTS:At T2, 44%, 39%, 17% were classified as normal fasting plasma glucose (FPG), IFG or diabetic, respectively. Odd ratios for diabetes were 4.2 for men with a family history of diabetes (FHD), 3.4 if BMI > or = 25 kg/m(2), 2.9 if waist girth > or = 90 cm, 2.8 if TG > or = 2 mmol/l and 1.9 if no daily dairy products were eaten. Still significant after adjustment for age, BMI, glucose and TG levels were: FHD (P=0.001), no daily dairy products (P=0.001), high alcohol intake (P=0.02) and low physical activity (P = 0.02). CONCLUSION:No daily dairy products, high alcohol intake and low physical activity were independent predictive factors of a 5-year onset of diabetes after adjusting for BMI, FHD, triglyceride and glucose levels at baseline. For a better prevention of diabetes, these findings give clues for behaviour modifications as soon as IFG is detected.
Insulin action and secretion in healthy Hispanic-Mexican first-degree relatives of subjects with type 2 diabetes.
Guerrer-Romer F,Rodríguez-Morán M,González-Ortiz M,Martínez-Abundis E
Journal of endocrinological investigation
The aim of this study was to assess the early insulin secretion and insulin action of healthy non-diabetic Hispanic-Mexican subjects with and without family history of Type 2 diabetes (FHD). One hundred and twenty non-relative subjects were compared against 115 first-degree relatives of individuals with Type 2 diabetes. To assign the subjects to the correspondent group, the FHD was carefully ascertained by clinical examination of the participants' parents. Age and gender were matched criteria. Incomplete or unclear data about FHD, previous diagnosis of diabetes or chronic diseases were exclusion criteria. Subjects in both groups were required to have fasting glucose <6.1 mmol/l, and 2-h PG<7.7 mmol/l. Insulin action and secretion were estimated by HOMA (homeostasis model insulin analysis resistance index) and insulinogenic index, respectively. Logistic regression analysis showed an independent relationship between BMI and insulin resistance (HOMA score >5.0) (odds ratio, OR, 1.42, p=0.03), and between FHD and insulin resistance (OR 1.27, p=0.04). On the other hand, there was a strong and independent relationship between FHD and high early insulin secretion (insulinogenic index >0.72) (OR 1.64, p=0.01) but not between BMI and high early insulin secretion (OR 0.93, p=0.3). Healthy Mexican first-degree relatives of subjects with Type 2 diabetes show an independent relationship between FHD and both high early insulin response and decreased insulin action, whereas BMI was only related to insulin resistance.
Predictors of abdominal adipose tissue compartments: 18-year follow-up of young men with and without family history of diabetes.
Skårn Sigrid Nordang,Eggesbø Heidi B,Flaa Arnljot,Kjeldsen Sverre E,Rostrup Morten,Brunborg Cathrine,Reims Henrik M,Aksnes Tonje Amb
European journal of internal medicine
BACKGROUND:Abdominal adipose tissue (AAT) consists of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), which can be further divided into superficial and deep SAT. Despite being a key factor in the development of metabolic and cardiovascular diseases, what predicts future amount of AAT is largely unknown. OBJECTIVE:To determine long-term predictors of amount of AAT. METHODS:This was a mean 18-year follow-up study of a cohort of 94 healthy young Caucasian men, with and without a family history of diabetes (FHD). Cardiovascular risk markers were examined both at baseline and at follow-up. At follow-up, computed tomography (CT) of AAT was conducted to assess amount of superficial and deep SAT, and VAT. RESULTS:In multiple regression analyses, baseline body mass index (BMI) remained a positive predictor of future amount of superficial and deep SAT, while high-density lipoprotein (HDL) cholesterol was a negative predictor of all three sub-compartments. Baseline risk markers were generally stronger predictors among men with FHD, than among men without. In addition, FHD had greater impact on amount of deep SAT and VAT, than on amount of superficial SAT. CONCLUSION:Our data suggest that the traditional cardiovascular risk markers BMI, HDL cholesterol and family history of diabetes are long-term predictors of the different abdominal adipose tissue compartments from young towards middle age in healthy men. In men with family history of diabetes, cardiovascular risk markers at a young age seem to be of greater importance to future amount of abdominal adipose tissue, than among men without.
Influence of family history of diabetes on incidence and prevalence of latent autoimmune diabetes of the adult: results from the Nord-Trøndelag Health Study.
Carlsson Sofia,Midthjell Kristian,Grill Valdemar
OBJECTIVE:The aim of this study was to investigate the association between family history of diabetes (FHD) and prevalence and incidence of latent autoimmune diabetes of the adult (LADA), type 1 diabetes, and type 2 diabetes. RESEARCH DESIGN AND METHODS:The results were based on cross-sectional data from 64,498 men and women (aged >or=20 years) who were in the Nord-Trøndelag Health Study, which included 128 cases of LADA, 1,134 cases of type 2 diabetes, and 123 cases of type 1 diabetes. In addition, prospective data on 46,210 subjects, which included 80 incident cases of LADA, observed between 1984 and 1986 and 1995 and 1997 were available. Patients with LADA had antibodies against GAD and were insulin independent at diagnosis. RESULTS:FHD was associated with a four times (odds ratio [OR] 3.92 [95% CI 2.76-5.58]) increased prevalence of LADA. Corresponding estimates for type 2 and type 1 diabetes were 4.2 (3.72-4.75) and 2.78 (1.89-4.10), respectively. Patients with LADA who had FHD had lower levels of C-peptide (541 vs. 715 pmol/l) and were more often treated with insulin (47 vs. 31%) than patients without FHD. Prospective data indicated that subjects with siblings who had diabetes had a 2.5 (1.39-4.51) times increased risk of developing LADA during the 11-year follow-up compared with those without. CONCLUSIONS:This study indicates that FHD is a strong risk factor for LADA and that the influence of family history may be mediated through a heritable reduction of insulin secretion.
Family history of diabetes is associated with higher risk for prediabetes: a multicentre analysis from the German Center for Diabetes Research.
Wagner Robert,Thorand Barbara,Osterhoff Martin A,Müller Gabriele,Böhm Anja,Meisinger Christa,Kowall Bernd,Rathmann Wolfgang,Kronenberg Florian,Staiger Harald,Stefan Norbert,Roden Michael,Schwarz Peter E,Pfeiffer Andreas F,Häring Hans-Ulrich,Fritsche Andreas
AIMS/HYPOTHESIS:Prediabetes is a collective term for different subphenotypes (impaired glucose tolerance [IGT] and/or impaired fasting glucose [IFG]) with different pathophysiologies. A positive family history for type 2 diabetes (FHD) is associated with increased risk for type 2 diabetes. We assumed that it would also associate with prediabetes, but wondered whether all subphenotypes are related to a positive family history. METHODS:In a study population of 8,106 non-diabetic individuals of European origin collected from four study centres (normal glucose tolerance, NGT n = 5,482, IFG and/or IGT n = 2,624), we analysed whether having at least one first degree relative with diabetes is associated with prediabetes. The analyses were performed using the same models in each population separately. Afterwards, a meta-analysis was performed. RESULTS:FHD was significantly associated with the risk for prediabetes (IFG and/or IGT, OR 1.40; 95% CI 1.27, 1.54). This association remained significant in multivariable logistic regression models including sex, age and BMI (OR 1.26; 95% CI 1.14, 1.40). When different prediabetic outcomes were considered separately, the association was found for isolated IFG (OR 1.37; 95% CI 1.20, 1.57), isolated IGT (OR 1.25; 95% CI 1.07, 1.46) as well as for the combination IFG+IGT (OR 1.64; 95% CI 1.40, 1.93). After stratification on BMI, association between FHD and prediabetes was seen only in non-obese individuals (BMI < 30 kg/m(2)). CONCLUSIONS/INTERPRETATION:We found that FHD is an important risk factor for prediabetes, especially for combined IGT and IFG. Its relevance seems to be more evident in the non-obese.
Early decrease of the percent of HOMA beta-cell function is independently related to family history of diabetes in healthy young nonobese individuals.
Guerrero-Romero F,Rodríguez-Morán M,González-Ortiz M,Martínez-Abundis E
Diabetes & metabolism
OBJECTIVE:To determine the relationship between family history of diabetes (FHD) and decrease in percent of HOMA beta-cell function (HOMA-beta%) index in healthy betanon-obese Mexican subjects. MATERIALS AND METHODS:Forty-eight individuals (30 women and 18 men) with FHD were compared vs 48 control subjects (30 women and 18 men) in a cross-sectional study matched by age, sex, and Waist-to-Hip ratio. Pregnancy, obesity, being overweight, alcohol consumption, high blood pressure, and heavy physical activity were exclusion criteria. All the participants were required to have a Body Mass Index < 25 kg/m2 and serum fasting and 2-hours postload glucose levels lower than 6.1 mmol/l and 7.8 mmol/l, respectively. The reciprocal of serum fasting insulin concentrations (1/Ins0) (microU/ml) and HOMA-B% index were used as indicators of insulin sensitivity and beta-cell function. RESULTS:Average age was of 19.4 +/- 3.6 vs 19.8 +/- 2.6, P = 0.66 for the subjects with and without FHD. HOMA-beta% index was significantly lower in the subjects with FHD (186.1 +/- 74.1 vs 252.7 +/- 149.5, P = 0.01). For similar levels of insulin sensitivity, subjects with FHD showed lower HOMA-beta% index than control subjects (P < 0.001). Multivariate regression analysis showed a strong and independent relationship between FHD and decrease of HOMA-beta% index (OR 2.6, CI95% 1.2-4.3, P = 0.01). CONCLUSIONS:This study shows that normal-weight offspring of type 2 diabetes subjects exhibited a significant decrease of HOMA-beta% index suggesting that FHD exerts an independent early negative effect on beta-cell function.
Family history of diabetes and risk of atherosclerotic cardiovascular disease in Korean men and women.
Park Ji Wan,Yun Ji Eun,Park Taesung,Cho Eorin,Jee Sun Ha,Jang Yangsu,Beaty Terri H,Samet Jonathan M
The importance of family history of type 2 diabetes (FHD) as a risk factor for atherosclerotic cardiovascular disease (ASCVD) remains controversial. A report of diabetes in parents and siblings was used to establish FHD in a cohort of 1,005,230 Koreans aged 30-95 years insured by the National Health Insurance Corporation who had a biennial medical evaluation during 1992-1995. ASCVD morbidity and mortality from 1993 to 2005 were examined in relation to FHD and other ASCVD risk factors. The risk of ischemic heart disease (IHD) increased significantly (19%) in men with FHD but not in women. A strong interaction was observed between FHD and personal history of diabetes for the occurrence of ASCVD; men with both diabetes and FHD were at significantly increased risk of developing IHD, cerebrovascular disease and ASCVD with hazard ratios (HR) of 2.28, 2.07, and 2.12, respectively, compared to those who had neither FHD nor type 2 diabetes. Corresponding risks were 2.64, 2.03, and 2.10 in women, respectively. This study demonstrates that risk of ASCVD is increased among those with diabetes and a family history of diabetes; suggesting that genetic factors associated with occurrence of familial diabetes may increase risk of ASCVD beyond the risk among people without FHD.
Risk of diabetes in subjects with sedentary profession and the synergistic effect of positive family history of diabetes.
Aravindalochanan Vigneswari,Kumpatla Satyavani,Rengarajan Manikandan,Rajan Rajeswari,Viswanathan Vijay
Diabetes technology & therapeutics
BACKGROUND:Sedentarism in the workplace, which accelerates risk of diabetes, is least explored in the Indian population. The primary objective of this study was to assess whether prolonged sitting hours in work place predisposes individuals to risk of diabetes and also to estimate risk of diabetes in sedentary workers with a positive family history of diabetes (FHD). SUBJECTS AND METHODS:Data of age-matched 514 subjects previously undiagnosed with diabetes from two different occupational groups (bank employees and schoolteachers) in Chennai, India from opportunistic screening were taken for analysis. The important explanatory variables were body mass index, waist circumference, duration of physical activity, positive FHD, and random capillary blood glucose (RCBG). Logistic regression analyses were done separately to identify determinants of diabetes in each group. Another logistic regression was performed after combining data to estimate risk associated with diabetes among sedentary subjects with positive FHD. RESULTS:Factors associated with elevated RCBG among schoolteachers were systolic and diastolic blood pressure, whereas among bank employees, in addition to blood pressure, duration of sitting in work place and positive FHD were significantly associated with diabetes. Combined data analysis showed that subjects with duration of sitting of ≥180 min/day and a positive FHD are three times at risk of developing diabetes. Adjusting for total physical activity revealed that risk was higher among male subjects. CONCLUSIONS:Increased sitting duration for ≥180 min/day at the workplace was associated with elevated RCBG. There was a threefold higher risk for diabetes among these subjects with positive FHD. Encouraging physical activities in such groups, particularly in men, can be beneficial.
Impact of family history of diabetes on β-cell function and insulin resistance among Chinese with normal glucose tolerance.
Chen Gang,Li Meizhi,Xu Yuan,Chen Nianhui,Huang Huibin,Liang Jixing,Li Liantao,Wen Junping,Lin Lixiang,Yao Jin
Diabetes technology & therapeutics
OBJECTIVE:This study investigated the impact of family history of diabetes (FHD) on β-cell function among Chinese with normal glucose tolerance. RESEARCH DESIGN AND METHODS:A multistage, stratified, cluster random sampling method was used to select a provincially representative sample from Fujian Province. Eventually, a total of 1,183 subjects were entered into the analysis. Several indexes were used to assess the function of β cells, including homeostasis model assessment (HOMA) of insulin resistance (IR), HOMA of β cells, insulinogenic index (IGI), and disposition index. RESULTS:Overweight, increased body mass index, higher low-density lipoprotein cholesterol, and higher total cholesterol (TC) were the dominant features of positive FHD (FHD(+)). The FHD(+) subjects had lower insulin sensitivity (P<0.05). FHD(+) subjects showed higher risk of IR after adjusting for other risk factors (odds ratio 1.523 [1.272-2.009]). However, there was no significant difference in insulin secretion between the two groups. With the use of the multiple linear regression model, waist circumference (WC) and triglycerides (TGs) were found to be independent risk factors of the decline of insulin sensitivity in FHD(+) subjects, and insulin sensitivity declined significantly (P<0.05) with the increase of WC and TGs. In addition, the offspring of fathers with diabetes (PT2D) were much older and had higher TC than those of mothers with diabetes (MT2D). After adjusting for gender of the parents, there was no difference between MT2D and PT2D on insulin sensitivity. CONCLUSIONS:Inheritance if diabetes is associated with the decline of insulin sensitivity. In addition, insulin sensitivity declined with increasing WC and TG in FHD(+) subjects.
Serum adiponectin is associated with family history of diabetes independently of obesity and insulin resistance in healthy Korean men and women.
Sull Jae Woong,Kim Hee Jin,Yun Ji Eun,Kim Grace,Park Eun Jung,Kim Soriul,Lee Hee Yeon,Jee Sun Ha
European journal of endocrinology
BACKGROUND:Adiponectin has been reported as a new risk factor for the development of diabetes. However, it is not clear whether adiponectin levels are associated with family history of diabetes (FHD). OBJECTIVE:The objective of this study was to measure the independent association of serum adiponectin with FHD in relation to insulin resistance and obesity. METHODS:In 2006, a cross-sectional study was conducted in which waist circumference (WC), body mass index (BMI), and serum adiponectin were measured in 5919 healthy Korean men and women. Multiple linear regression models were used to assess the association of serum adiponectin levels with FHD. The population was classified into two groups according to median values for each of the following variables: WC, BMI, and homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS:The positive FHD group had higher HOMA-IR and lower adiponectin levels in both men and women than those without FHD. Adiponectin levels were significantly associated with FHD in men and women respectively, after adjusting for age, BMI, and alcohol consumption (P=0.0123 and 0.0004). The relationship between adiponectin and FHD was similar between the high and low insulin resistance, BMI, and WC groups in male non-smokers and in all Korean women. CONCLUSION:These results confirm that adiponectin levels are associated with FHD. These data also suggest that the association of serum adiponectin with FHD may be independent of obesity and insulin resistance.
Factors associated with insulin resistance and fasting plasma ghrelin levels in adolescents with obesity and family history of type 2 diabetes.
Liu Bo-wei,Lu Quiang,Ma Chun-ming,Wang Shu-yi,Lou Dong-hui,Lou Xiao-li,Yin Fu-zai
Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
OBJECTIVE:To investigate the changes of insulin resistance and fasting plasma ghrelin levels in adolescents with obesity and family history of type 2 diabetes mellitus (FHD) and analyze its related factors. METHODS:The study included 159 adolescents aged 13-15 years. Anthropometric- measurements, including height, weight and waist. Blood samples were collected and fasting plasma glucose (FPG), serum lipids, true insulin (TI) and fasting plasma ghrelin were assayed. They were divided into four groups according to body mass index (BMI) and FHD: 40 non-obese adolescents without FHD in group A; 40 overweight and obese adolescents without FHD in group B; 40 non-obese adolescents with FHD in group C; 39 overweight and obese adolescents with FHD in group D. RESULTS:Group B, C and D had significantly higher levels of HOMA-IR and HOMA-beta index than group A, especially Group D (p<0.01). Group C and D had significantly higher levels of FPG and lower levels of ghrelin than group A (p<0.01). HOMA-IR showed positive correlation with BMI (r=0.445), waist (r=0.435), waist-to-height ratio (WHtR)(r=0.471) (p<0.01). Ghrelin showed negative correlation with FPG (r=-0.339), TI (r=-0.237) and HOMA-IR (r=-0.269) (p<0.01). In multiple linear regression analysis, WHtR (beta=4.925, p=0.000) and FHD (beta=0.492, p=0.000) were significant independent predictors for HOMA-IR. FHD (beta=-289.856, p=0.000) and FPG (beta=-228.203, p=0.001) were significant independent predictors for ghrelin. CONCLUSION:This study showed that the subjects with FHD and obesity who are predisposed to diabetes have insulin resistance in adolescent stage. The lower ghrelin levels in subjects with FHD may be the result of elevated FPG.
Obesity and family history of diabetes as risk factors of impaired fasting glucose: implications for the early detection of prediabetes.
Rodríguez-Moran Martha,Guerrero-Romero Fernando,Aradillas-García Celia,Violante Rafael,Simental-Mendia Luis E,Monreal-Escalante Elizabeth,Mendoza Esperanza de la Cruz
OBJECTIVE:To determine whether the association between family history of diabetes (FHD) and impaired fasting glucose (IFG) is independent of body mass index (BMI) in children and adolescents. METHODS:In all 443 (11.9%) children and adolescents with FHD, and 3280 (88.1%) without FHD were enrolled in a population-based cross-sectional study. Eligible subjects to participate were apparently healthy children and adolescents aged 7-15 yr from Middle and Northern Mexico. Obesity was defined by age- and gender-specific BMI >or= 95th percentile. FHD was defined as positive if at least one first degree relative had diabetes. The IFG was defined by fasting plasma glucose >or= 100 mg/dL and < 126 mg/dL. RESULTS:IFG was identified in 390 (88.0%) and 62 (1.9%) children and adolescents with and without FHD, respectively. In the group with positive FHD, IFG was diagnosed in 146 (37.4%), 79 (20.2%), and 165 (42.3%) children and adolescents who were obese, overweight, and normal-weight, respectively. On the other hand, in the group without FHD, IFG was identified in 21 (33.9%), 14 (22.6%), and 27 (43.5%) children and adolescents who were obese, overweight, and normal-weight, respectively. In the overall population, the age-, sex-, and BMI-adjusted logistic regression analysis showed a strong and independent association between FHD and IFG [odds ratio (OR) -11.7; 95% CI 9.5-21.2]. This association remained strong for girls and boys in a subsequent analysis stratified for BMI category. CONCLUSIONS:The presence of FHD in a first degree relative is associated with IFG, even in the absence of obesity.
Low serum adiponectin levels in Korean children with a family history of type 2 diabetes mellitus.
Oh Yeon Joung,Nam Hyo-Kyoung,Rhie Young Jun,Park Sang Hee,Lee Kee-Hyoung
Hormone research in paediatrics
BACKGROUND/AIMS:The current worldwide increases of type 2 diabetes mellitus (T2DM) in children coincide with increases in the prevalence of obesity. We investigated the insulin resistance and adiponectin levels of children and adolescents with a family history of T2DM (FHD). METHODS:Our sample included 131 children and adolescents aged 8-15 years. Fasting plasma glucose, lipids, fasting insulin, adiponectin levels and HOMA-IR were analyzed according to FHD and obesity. Oral glucose tolerance tests were performed in all subjects except non-obese subjects without FHD. RESULTS:Adiponectin levels of subjects with FHD were significantly lower than those of subjects without FHD in both the obese and nonobese groups. HOMA-IR was significantly higher in obese subjects with FHD than in those without FHD. Adiponectin levels were found to be independently associated with FHD and Matsuda index. The frequency of impaired glucose tolerance in obese subjects with FHD was more than four times higher compared to obese subjects without FHD. CONCLUSION:Our results suggest that FHD could be a risk factor of T2DM in obese Korean children, especially with low serum levels of adiponectin.
Family history of diabetes is associated with diabetic foot complications in type 2 diabetes.
Xiong Xiao-Fen,Wei Ling,Xiao Ying,Han Ya-Chun,Yang Jinfei,Zhao Hao,Yang Ming,Sun Lin
To investigate the relationship between diabetic foot complications (DFCs) and clinical characteristics, especially the number and types of first-degree family members with diabetes. A total of 8909 type 2 diabetes patients were enrolled. The clinical characteristics of these patients, including DFCs and family history of diabetes (FHD), were collected from medical records. Multiple regression was used to investigate the association between FHD and DFCs after adjusting for confounding factors. The patients with one and more than one first-degree family member with diabetes accounted for 18.7% and 12.8%, respectively. The proportions of the participants with a father with diabetes, a mother with diabetes, both parents with diabetes, siblings with diabetes, father and siblings with diabetes, mother and siblings with diabetes, and both parents and siblings with diabetes were 3.5%, 6.2%, 1.1%, 14.4%, 1.5%, 4%, and 0.7%, respectively. The multiple regression analysis showed that the number of family members with diabetes was positively associated with DFCs. However, among the different types of FHD, only the patients with a mother with diabetes showed a statistical association with DFCs. In addition to FHD, other factors, including gender, body mass index, platelet count, hemoglobin levels, albumin levels, high-density cholesterol levels, diabetic peripheral neuropathy, and the use of lipid-lowering agents, oral hypoglycemic agents, and insulin, were also associated with DFCs. DFCs were associated with different numbers of family members with diabetes and types of FHD. This association reveals the importance of genetic and environmental factors in DFCs and highlights the importance of adding FHD to public health strategies targeting detecting and preventing the disease.
Effect of Family History of Diabetes on Hemoglobin A1c Levels among Individuals with and without Diabetes: The Dong-gu Study.
Lee Young Hoon,Shin Min Ho,Nam Hae Sung,Park Kyeong Soo,Choi Seong Woo,Ryu So Yeon,Kweon Sun Seog
Yonsei medical journal
PURPOSE:We investigated associations between family history of diabetes (FHD) and hemoglobin A1c (HbA1c) level, among people with and without diabetes. MATERIALS AND METHODS:In total, 7031 people without diabetes and 1918 people with diabetes who participated in the Dong-gu Study were included. Data on FHD in first-degree relatives (father, mother, and siblings) were obtained. Elevated HbA1c levels in people without diabetes and high HbA1c levels in people with diabetes were defined as the highest quintiles of HbA1c ≥5.9% and ≥7.9%, respectively. RESULTS:In people without diabetes, the odds of elevated HbA1c levels [odds ratio (OR) 1.34, 95% confidence interval (CI) 1.13-1.59] were significantly greater in people with any FHD than in those without. Specifically, the odds of elevated HbA1c levels in people without diabetes with an FHD involving siblings were greater than in those without an FHD involving siblings. Additionally, in people with diabetes, the odds of high HbA1c levels (OR 1.33, 95% CI 1.02-1.72) were greater in people with any FHD than in those without such history. Moreover, people with diabetes with maternal FHD had increased odds of high HbA1c levels. CONCLUSION:FHD was associated not only with high HbA1c levels in people with diabetes, but also with elevated HbA1c levels in people without diabetes.
Elevation in fibroblast growth factor 23 and its value for identifying subclinical atherosclerosis in first-degree relatives of patients with diabetes.
Hu Xiang,Ma Xiaojing,Luo Yuqi,Xu Yiting,Xiong Qin,Pan Xiaoping,Bao Yuqian,Jia Weiping
Accumulating evidence supported an association between diabetes and fibroblast growth factor 23 (FGF23). The goal of the present study was to explore alteration in serum FGF23 levels and to assess its value for identifying subclinical atherosclerosis in normoglycemic individuals with a first-degree family history of diabetes (FHD). The study enrolled 312 subjects with a first-degree FHD and 1407 subjects without an FHD. Serum FGF23 levels were detected by a sandwich enzyme-linked immunosorbent assay. Serum FGF23 levels were much higher in subjects with a first-degree FHD than in those without an FHD (P = 0.006). A first-degree FHD was positively associated with serum FGF23 levels, independent of C-IMT and cardiovascular factors (both P < 0.05). In subjects with a first-degree FHD, only those with serum FGF23 levels in the upper quartile were more likely to have an increased C-IMT (odds ratio = 2.263, P < 0.05). As conclusions, a first-degree FHD contributes to the increased serum FGF23 levels independently. Subjects with a first-degree FHD need higher serum FGF23 levels to indicate subclinical atherosclerosis. The influence of a first-degree FHD on serum FGF23 levels should be considered to avoid overestimating the risk of cardiovascular disease in normoglycemic individuals with a first-degree FHD.
Synergistic Effect of Family History of Diabetes and Dietary Habits on the Risk of Type 2 Diabetes in Central China.
Zhao Yanyan,Song Chunhua,Ma Xiaokun,Ma Xiaojun,Wang Qingzhu,Ji Hongfei,Guo Feng,Qin Guijun
International journal of endocrinology
. Family history of diabetes (FHD) and lifestyle are associated with type 2 diabetes (T2DM), but little is known about the FHD diet interactions. We aimed to analyze the interactions of FHD and lifestyle factors in Chinese T2DM onset. . This was a cross-sectional survey in central urban China ( = 1234 patients with T2DM and = 8615 non-T2DM subjects). The biological interactions, defined by Rothman interactions, between FHD and each dietary factor were analyzed by using the synergy index () scores. . After adjustment for age, gender, BMI, and WHR, a uniparental FHD (OR = 2.84, 95% CI: 2.36-3.42, < 0.001), a paternal history of FHD (OR = 2.53, 95% CI: 1.91-3.35, < 0.001), a maternal history of FHD (OR = 3.27, 95% CI: 2.67-4.02, < 0.001), a biparental history of FHD (OR = 5.26, 95% CI: 2.98-9.31, < 0.001), and a FHD, irrespective of the parent (OR = 3.59, 95% CI: 3.08-4.17, < 0.001), were associated with T2DM onset. There were significant interactions between FHD and consuming <15 g/d of potatoes ( = 1.54, 95% CI: 1.12-2.12), <8 g/d of poultry ( = 1.51, 95% CI: 1.04-2.17), <85 g/d of fresh fruits ( = 2.17, 95% CI: 1.63-2.88), and no freshly squeezed juice ( = 2.25, 95% CI: 1.46-3.49). . Risk of T2DM was synergistically affected by FHD and dietary habits. Nutrition educational intervention may decrease the prevalence of T2DM in the Chinese with FHD.
Association of bone mineral density with a first-degree family history of diabetes in normoglycemic postmenopausal women.
Yang Lijuan,Hu Xiang,Zhang Hailing,Pan Wei,Yu Weihui,Gu Xuejiang
Menopause (New York, N.Y.)
OBJECTIVE:A first-degree family history of diabetes (FHD) contributes to increased risks of metabolic and cardiovascular diseases. Bone is an insulin-resistant site and an organ susceptible to microvascular complications. The goal of the present study was to investigate the association of FHD with bone mineral density (BMD) in postmenopausal women. METHODS:In all, 892 normoglycemic postmenopausal women were divided into subgroups of participants with or without a first-degree FHD. BMD was measured using dual-energy x-ray absorptiometry. Fasting plasma insulin and glucose levels were measured, and insulin resistance was evaluated using the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index. RESULTS:The BMD of the lumbar spine and femoral neck were much higher in the participants with a first-degree FHD than in those without an FHD (all P < 0.05). Lumbar spine BMD and femoral neck BMD were both positively associated with HOMA-IR (P = 0.041 and P = 0.005, respectively). Multiple stepwise regression analysis showed that a first-degree FHD was an independent factor that was positively associated with lumbar spine BMD (standardized β = 0.111, P = 0.001) and femoral neck BMD (standardized β = 0.078, P = 0.021). A first-degree FHD was associated with increased BMD, insulin resistance, and hyperinsulinemia. CONCLUSIONS:Our study indicated that normoglycemic postmenopausal women with a first-degree FHD exhibit increased BMD with insulin resistance and hyperinsulinemia. A first-degree FHD was an independent factor associated with elevated BMD in Chinese women after menopause.
Impact of sleep-disordered breathing on glucose metabolism among individuals with a family history of diabetes: the Nagahama study.
Minami Takuma,Matsumoto Takeshi,Tabara Yasuharu,Gozal David,Smith Dale,Murase Kimihiko,Tanizawa Kiminobu,Takahashi Naomi,Nakatsuka Yoshinari,Hamada Satoshi,Handa Tomohiro,Takeyama Hirofumi,Oga Toru,Nakamoto Isuzu,Wakamura Tomoko,Komenami Naoko,Setoh Kazuya,Tsutsumi Takanobu,Kawaguchi Takahisa,Kamatani Yoichiro,Takahashi Yoshimitsu,Morita Satoshi,Nakayama Takeo,Hirai Toyohiro,Matsuda Fumihiko,Chin Kazuo,
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
STUDY OBJECTIVES:It is well known that a family history of diabetes (FHD) is a definitive risk factor for type 2 diabetes. It has not been known whether sleep-disordered breathing (SDB) increases the prevalence of diabetes in those with FHD. METHODS:We assessed SDB severity in 7,477 study participants by oximetry corrected by objective sleep duration determined by wrist actigraphy. HbA1c ≥6.5% and/or current medication for diabetes indicated the presence of diabetes. In addition to the overall prevalence, the prevalence of recent-onset diabetes during the almost 5 years before the SDB measurements was investigated. RESULTS:Of the 7,477 participants (mean age 57.9 [range 34.2-80.7, SD 12.1] years, females 67.7%), 1,569 had FHD. The prevalence of diabetes in FHD participants with moderate-to-severe SDB (MS-SDB) was higher than in those without SDB (MS-SDB vs. without SDB: all, 29.3% vs. 3.3%, P <0.001; females, 32.6% vs. 1.9%, P <0.001; males, 26.2% vs. 11.7%, P = 0.037). However, multivariate analysis showed that MS-SDB was significantly associated with a higher prevalence of diabetes only in FHD (+) females (OR [95%CI]: females, 7.43 [3.16-17.45]; males, 0.92 [0.37-2.31]). Among the FHD (+) participants, the prevalence of recent-onset diabetes was higher in those with MS-SDB than those without SDB, but only in females (MS-SDB vs. without SDB: 21.4 % vs. 1.1%, P <0.001). CONCLUSIONS:MS-SDB was associated with diabetes risk in females with FHD, and future studies are needed on whether treatment of SDB in females with FHD would prevent the onset of diabetes.
Serum ferritin, an early marker of cardiovascular risk: a study in Chinese men of first-degree relatives with family history of type 2 diabetes.
Liu Jun-Ru,Liu Yang,Yin Fu-Zai,Liu Bo-Wei
BMC cardiovascular disorders
BACKGROUND:Ferritin is one of the key proteins that regulate iron homeostasis and is widely available clinical biomarker of iron status. This study aimed to discuss the influence of serum ferritin (SF) on cardiovascular risk factors in the first-degree relatives with family history of type 2 diabetes (FHD). METHODS:This cross-sectional study included 232 men. Anthropometric measurements and blood samples were analyzed. The people were divided into four groups according to median SF (102.8 ng/ml) and people with or without FHD. Group A (FHD-and low SF), group B (FHD-and high SF), group C (FHD+ and low SF), and group D (FHD+ and high SF). RESULTS:The subjects in different categories of SF concentrations showed significant differences in BMI (SF main effect: P = 0.010), WC (P = 0.030), SBP (P < 0.001), FPG (P < 0.001), PPG-2 h (P < 0.001), FINS (P < 0.001), and HOMA-IR (P = 0.015; all: 2-way ANOVA). There was a significant difference in SBP (FHD main effect: P = 0.003), DBP (P = 0.006), and FINS (P = 0.013, all: 2-way ANOVA) between the groups with or without FHD. The interaction term between SF and FHD was significant for SBP (P = 0.011), DBP (P = 0.012), and PPG-2 h (P = 0.022). Logistic analysis showed that accumulation of CVD risk factors, which were ≥ 2 items and ≥ 3 items in group D were 7.546 and 3.343 times higher compared with group A (P < 0.05). CONCLUSIONS:The increased SF levels increased the risk of cardiovascular risk factors and the occurrence of insulin resistance in first-degree relatives with FHD.
Decreased arterial distensibility and postmeal hyperinsulinemia in young Japanese women with family history of diabetes.
Takeuchi Mika,Wu Bin,Honda Mari,Tsuboi Ayaka,Kitaoka Kaori,Minato Satomi,Kurata Miki,Kazumi Tsutomu,Fukuo Keisuke
BMJ open diabetes research & care
INTRODUCTION:To assess vascular function and characterize insulin secretion using a physiological approach in Japanese women with family history of type 2 diabetes (FHD). RESEARCH DESIGN AND METHODS:Standardized mixed-meal tests were performed with multiple postprandial glucose, insulin and free fatty acids (FFA) measurements over a 30-120 min period in 31 Japanese women aged 21-24 years. Arterial distensibility was assessed as well. RESULTS:Fasting glucose, triglyceride and insulin averaged <90 mg/dL, <60 mg/dL and <5 μU/mL, respectively, and did not differ cross-sectionally between 10 with (FHD+) and 21 without FHD (FHD-). FHD+ showed higher insulin responses not only during the first 30 min (p=0.005) but also during the second hour (60-120 min, p<0,05) in spite of identical postprandial suppression of FFA and identical fasting and postprandial glucose and FFA concentrations, except for higher 60 min FFA in FHD+. Further, FHD+ had decreased arterial distensibility (p=0.003). On multivariate regression analysis, arterial distensibility emerged as the only significant independent predictor of FHD+. Endurance training in FHD+ did not alter decreased arterial distensibility whereas it abolished postprandial hyperinsulinemia. CONCLUSIONS:FHD was associated with decreased arterial distensibility and postprandial hyperinsulinemia despite nearly identical postprandial glycemia and postprandial FFA suppression, suggesting that impaired vascular insulin sensitivity may precede glucose and lipid dysmetabolism in normal weight Japanese women aged 22 years.
Family history of diabetes in both parents is strongly associated with impaired residual β-cell function in Japanese type 2 diabetes patients.
Iwata Minoru,Kamura Yutaka,Honoki Hisae,Kobayashi Kaori,Ishiki Manabu,Yagi Kunimasa,Fukushima Yasuo,Takano Atsuko,Kato Hiromi,Murakami Shihou,Higuchi Kiyohiro,Kobashi Chikaaki,Fukuda Kazuhito,Koshimizu Yukiko,Tobe Kazuyuki
Journal of diabetes investigation
AIMS/INTRODUCTION:The objective of the present study was to clarify the association of the type and number of first-degree family history of diabetes (FHD) with the clinical characteristics, especially with residual β-cell function, in type 2 diabetes patients. MATERIALS AND METHODS:A total of 1,131 type 2 diabetes patients were recruited and divided into four groups according to FHD information as follows: (i) patients without FHD (FHD-); (ii) those with at least one sibling who had diabetes without parental diabetes (FHD+); (iii) those with one parent (FHD++); or (iv) those with both parents (FHD+++) who had diabetes with or without a sibling with diabetes. RESULTS:The percentages of the FHD-, FHD+, FHD++ and FHD+++ groups were 49.4%, 13.4%, 34.0% and 3.2%, respectively. Patients in the FHD++ and FHD+++ groups were significantly younger at the time of diabetes diagnosis (P < 0.001) than those in the FHD- and FHD+ groups, even after adjusting for confounding factors. In addition, the levels of insulin secretion were significantly lower in the patients in the FHD+, FHD++ and FHD+++ groups than those in the FHD- group (P < 0.05) after adjusting for confounding factors, and the patients in the FHD+++ group presented with the lowest levels of insulin secretion among the four groups. CONCLUSIONS:Our results showed that in type 2 diabetes patients, the degree of the associations between FHD and clinical characteristics differs according to the number and the type of FHD. In particular, FHD in both parents is most strongly associated with impaired residual β-cell function.