Department of Internal Medicine, Division of Endocrinology, Eberhard Karls University, Otfried-Müller-Str 10, 72076 Tübingen, Germany.
Diabetologia. 2013 Oct;56(10):2176-80. doi: 10.1007/s00125-013-3002-1. Epub 2013 Aug 24.
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.
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.
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.
目的/假设:糖尿病前期是不同亚表型(糖耐量受损[IGT]和/或空腹血糖受损[IFG])的统称,具有不同的病理生理学机制。2 型糖尿病阳性家族史(FHD)与 2 型糖尿病风险增加相关。我们假设它也与糖尿病前期有关,但想知道是否所有亚表型都与阳性家族史有关。
在来自四个研究中心的 8106 名非糖尿病欧洲血统个体的研究人群中(正常糖耐量,NGT n=5482,IFG 和/或 IGT n=2624),我们分析了至少有一位一级亲属患有糖尿病是否与糖尿病前期有关。使用相同的模型在每个人群中分别进行分析。然后进行荟萃分析。
FHD 与糖尿病前期(IFG 和/或 IGT)的风险显著相关(OR 1.40;95%CI 1.27,1.54)。在包括性别、年龄和 BMI 的多变量逻辑回归模型中,这种关联仍然显著(OR 1.26;95%CI 1.14,1.40)。当分别考虑不同的糖尿病前期结局时,发现孤立性 IFG(OR 1.37;95%CI 1.20,1.57)、孤立性 IGT(OR 1.25;95%CI 1.07,1.46)以及 IFG+IGT 联合(OR 1.64;95%CI 1.40,1.93)存在相关性。在 BMI 分层后,仅在非肥胖个体(BMI<30kg/m2)中观察到 FHD 与糖尿病前期之间的关联。
结论/解释:我们发现 FHD 是糖尿病前期的一个重要危险因素,尤其是对于联合 IGT 和 IFG。其相关性在非肥胖者中更为明显。