Impact of family history on relations between insulin resistance, LDL cholesterol and carotid IMT in healthy adults. Issue 15 (16th July 2010)

• Record Type: Journal Article
• Authors: Anderwald, Christian; Stadler, Marietta; Golay, Alain; Krebs, Michael; Petrie, John; Luger, Anton
• Is Part Of: Heart. Volume 96:Issue 15(2010)
• Page Start: 1191
• Page End: 1200
• Publication Date: 2010-07-16
• Subjects: Insulin resistance -- vascular disease -- low-density-lipoprotein cholesterol -- atherosclerosis -- metabolic syndrome -- endocrinology -- cerebral protection; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2009.177436
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: Insulin resistance (IR) is implicated as an independent risk factor for vascular disease. The aim of this study was to assess the impact of family history (FH) of type 2 diabetes (T2DM) and/or cardiovascular disease (CVD) on the associations between IR, low-density-lipoprotein cholesterol (LDL-C) and subclinical atherosclerosis (common and internal carotid artery intima media thickness (IMT)) in healthy European adults. Methods: Participants (n=1048) in the Relationship between Insulin Sensitivity and Cardiovascular disease (RISC) study were grouped according to family history of: (i) type 2 diabetes (FH-T2DM); (ii) cardiovascular disease (FH-CVD); (iii) both (FH-BOTH); or (iv) neither (CON). Insulin resistance (M-value, hyperinsulinaemic euglycaemic clamp), LDL-C and IMT were examined in relation to FH in all available participants, and then within subcohorts (highest quintiles) with higher LDL-C (>3.5 mmol/l (>135 mg/dl), n=252) or greater IR (M-value<5 mg/min/kg, n=299). Results: Carotid IMTs were comparable across the four FH groups, but insulin sensitivity (M-value) was lower (p<0.01) in FH-T2DM (6.1±2.6 mg/min/kg than in either CON (6.9±2.9 mg/min/kg) or FH-CVD (7.1±2.7 mg/min/kg). Within the highest LDL-C quintile, those with FH-CVD (or FH-BOTH) had higher common and internal carotid IMT (6–12%, p<0.05 vs CON). In contrast, within the most IR quintile, FH-CVD was not associated with IMT. Conclusion: In this cross-sectional analysis, family history of T2DM (but not of CVD) was associated with IR. In the presence of elevated LDL-C, FH-CVD (but not FH-T2DM) was associated with increased carotid IMT.