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2型糖尿病家族史对体重正常、超重及肥胖的糖耐量正常年轻成年人颈总动脉内膜中层厚度的影响。

Effect of family history of type 2 diabetes on the intima-media thickness of the common carotid artery in normal-weight, overweight, and obese glucose-tolerant young adults.

作者信息

Pannacciulli Nicola, De Pergola Giovanni, Ciccone Marco, Rizzon Paolo, Giorgino Francesco, Giorgino Riccardo

机构信息

Internal Medicine, Endocrinology, and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.

出版信息

Diabetes Care. 2003 Apr;26(4):1230-4. doi: 10.2337/diacare.26.4.1230.

Abstract

OBJECTIVE

To evaluate the effect of a first-degree family history of type 2 diabetes on the intima-media thickness of the common carotid artery (IMT-CCA), a surrogate marker of coronary atherosclerosis, in glucose-tolerant young adults.

RESEARCH DESIGN AND METHODS

IMT-CCA was measured by high-resolution B-mode ultrasound imaging in 401 individuals aged 18-45 years with normal glucose tolerance (NGT). A total of 213 subjects had no family history of type 2 diabetes until the third generation (FH(-)), and 188 subjects had a family history of type 2 diabetes (FH(+)), defined as having one or both parents with type 2 diabetes. Other measurements included: central fat accumulation, evaluated by waist circumference; insulin resistance, estimated by homeostasis model assessment for insulin resistance (HOMA(IR)); systolic and diastolic blood pressure; fasting and postload concentrations of glucose; fasting insulin levels; and lipid profile.

RESULTS

IMT-CCA and both 1- and 2-h postchallenge glucose concentrations were significantly higher in FH(+) than in FH(-) subjects. IMT-CCA was positively correlated with age, BMI, waist circumference, triglycerides, systolic and diastolic blood pressure levels, basal glucose concentrations, 1- and 2-h postchallenge glucose concentrations, and HOMA(IR). IMT-CCA was inversely associated with HDL cholesterol. After multivariate analysis, IMT-CCA maintained a significant association with family history of type 2 diabetes, BMI, waist circumference, HDL cholesterol, diastolic blood pressure, and fasting glucose.

CONCLUSIONS

This study indicates that a genetic predisposition to type 2 diabetes, probably in association with slightly elevated glucose levels, may accelerate the development of atherosclerosis and increase the risk for coronary heart disease in glucose-tolerant individuals.

摘要

目的

评估2型糖尿病一级家族史对糖耐量正常的年轻成年人颈总动脉内膜中层厚度(IMT-CCA)的影响,IMT-CCA是冠状动脉粥样硬化的替代标志物。

研究设计与方法

采用高分辨率B型超声成像测量401名年龄在18-45岁、糖耐量正常(NGT)个体的IMT-CCA。共有213名受试者三代以内无2型糖尿病家族史(FH(-)),188名受试者有2型糖尿病家族史(FH(+)),定义为父母一方或双方患有2型糖尿病。其他测量指标包括:通过腰围评估中心性脂肪堆积;通过稳态模型评估胰岛素抵抗(HOMA(IR))估计胰岛素抵抗;收缩压和舒张压;空腹及负荷后血糖浓度;空腹胰岛素水平;以及血脂谱。

结果

FH(+)受试者的IMT-CCA以及餐后1小时和2小时血糖浓度均显著高于FH(-)受试者。IMT-CCA与年龄、体重指数、腰围、甘油三酯、收缩压和舒张压水平、基础血糖浓度、餐后1小时和2小时血糖浓度以及HOMA(IR)呈正相关。IMT-CCA与高密度脂蛋白胆固醇呈负相关。多变量分析后,IMT-CCA与2型糖尿病家族史、体重指数、腰围、高密度脂蛋白胆固醇、舒张压和空腹血糖仍保持显著关联。

结论

本研究表明,2型糖尿病的遗传易感性可能与血糖水平轻度升高相关,可能会加速糖耐量正常个体的动脉粥样硬化发展并增加冠心病风险。

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