Mitchell B D, Almasy L A, Rainwater D L, Schneider J L, Blangero J, Stern M P, MacCluer J W
Department of Genetics, Southwest Foundation for Biomedical Research, San Antonio, TX 78245-0549, USA.
Am J Epidemiol. 1999 Jun 1;149(11):1047-56. doi: 10.1093/oxfordjournals.aje.a009750.
There is a strong familial predisposition to type 2 diabetes, hypertension, and cardiovascular disease. The authors evaluated the association between a family history of these diseases and a large panel of cardiovascular risk factors in 1,431 Mexican American subjects who were enrolled in the San Antonio Family Heart Study in San Antonio, Texas. The baseline phase of the study covered 1992-1996. Diabetes and hypertension were diagnosed according to standard clinical criteria, while cardiovascular disease was defined as a history of heart attack or heart surgery. The prevalence of diabetes, hypertension, and cardiovascular disease in this population was 15%, 12%, and 3%, respectively. For each unaffected subject, the authors computed a family history score based on the presence or absence of disease in parents and older siblings, and correlations between cardiovascular risk factors and family history scores were estimated by using likelihood-based variance component methods. Diabetes family history score was significantly correlated with a broad panel of cardiovascular risk factors, including glucose and insulin, obesity, blood pressure, triglycerides, and total cholesterol. Hypertension family history score was significantly correlated with glucose, blood pressure, body mass index, waist circumference, total cholesterol, and triglycerides. These results support the idea that genes that confer a risk for diabetes, and to a lesser extent hypertension, adversely alter the cardiovascular risk profile long before the manifestation of clinical disease.
2型糖尿病、高血压和心血管疾病存在很强的家族易感性。作者在1431名参加了得克萨斯州圣安东尼奥市圣安东尼奥家族心脏研究的墨西哥裔美国人中，评估了这些疾病的家族史与大量心血管危险因素之间的关联。该研究的基线阶段涵盖1992年至1996年。糖尿病和高血压根据标准临床标准诊断，而心血管疾病定义为有心脏病发作或心脏手术史。该人群中糖尿病、高血压和心血管疾病的患病率分别为15%、12%和3%。对于每一位未患病的受试者，作者根据其父母和年长同胞中疾病的有无计算家族史得分，并使用基于似然的方差成分方法估计心血管危险因素与家族史得分之间的相关性。糖尿病家族史得分与一系列广泛的心血管危险因素显著相关，包括血糖和胰岛素、肥胖、血压、甘油三酯和总胆固醇。高血压家族史得分与血糖、血压、体重指数、腰围、总胆固醇和甘油三酯显著相关。这些结果支持这样一种观点，即赋予糖尿病风险的基因，以及在较小程度上赋予高血压风险的基因，早在临床疾病表现出来之前就会对心血管风险状况产生不利影响。
