Cargando…

Metabolic predictors of impaired glucose tolerance and type 2 diabetes in a predisposed population – A prospective cohort study

BACKGROUND: We characterized in detail (oral and intravenous glucose tolerance tests (OGTT and IVGTT), euglycemic hyperinsulinemic clamp, adipose tissue biopsy), healthy first-degree relatives (FDR) of individuals with type 2 diabetes (T2D), to examine predictive factors for future development of im...

Descripción completa

Detalles Bibliográficos
Autores principales: Henninger, Josefin, Hammarstedt, Ann, Rawshani, Araz, Eliasson, Björn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583989/
https://www.ncbi.nlm.nih.gov/pubmed/26407933
http://dx.doi.org/10.1186/s12902-015-0048-8
_version_ 1782391916745195520
author Henninger, Josefin
Hammarstedt, Ann
Rawshani, Araz
Eliasson, Björn
author_facet Henninger, Josefin
Hammarstedt, Ann
Rawshani, Araz
Eliasson, Björn
author_sort Henninger, Josefin
collection PubMed
description BACKGROUND: We characterized in detail (oral and intravenous glucose tolerance tests (OGTT and IVGTT), euglycemic hyperinsulinemic clamp, adipose tissue biopsy), healthy first-degree relatives (FDR) of individuals with type 2 diabetes (T2D), to examine predictive factors for future development of impaired glucose tolerance (IGT) or T2D. METHODS: Non-diabetic FDR (n = 138, mean age 40.5 ± 6.5 years, 57 % women) underwent an extended OGTT every 3 years to assess any deterioration in glucose tolerance status. Differences between groups were assessed by logistic fit for continuous variables and by contingency analysis for categorical variables. Multiple logistic regression analysis was applied to adjust for confounding variables. RESULTS: At follow-up (mean 5.6 ± 2.4 years) 19 subjects had IGT and 4 had T2D. At baseline these 23 subjects had more family members with T2D, higher fasting plasma glucose, higher OGTT plasma glucose at 120 min, higher HbA1c, lower M-value and higher total cholesterol compared to subjects with normal glucose tolerance (NGT). There were significantly larger changes in weight, BMI, fasting plasma glucose, OGTT plasma glucose at 120 min and HbA1c in individuals developing IGT or T2D during the follow-up period than the subjects remaining NGT. Crude predictors of deteriorating glucose tolerance were age, family history of diabetes and of hypertension, OGTT plasma glucose levels at 60 min, 90 min, and 120 min, as well as serum bilirubin, ALP and creatinine (p-values <0.05). A multiple nominal logistic regression model revealed that male sex, low M-value and high physical exercise (p-values <0.05) predicted development of IGT/T2DM. CONCLUSION: In sum, genetically predisposed individuals for T2D with deteriorating glucose tolerance exhibit insulin resistance as well as beta-cell and signs of adipose tissue dysfunction, emphasizing the multifactorial pathophysiology in the development of IGT and T2D.
format Online
Article
Text
id pubmed-4583989
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-45839892015-09-28 Metabolic predictors of impaired glucose tolerance and type 2 diabetes in a predisposed population – A prospective cohort study Henninger, Josefin Hammarstedt, Ann Rawshani, Araz Eliasson, Björn BMC Endocr Disord Research Article BACKGROUND: We characterized in detail (oral and intravenous glucose tolerance tests (OGTT and IVGTT), euglycemic hyperinsulinemic clamp, adipose tissue biopsy), healthy first-degree relatives (FDR) of individuals with type 2 diabetes (T2D), to examine predictive factors for future development of impaired glucose tolerance (IGT) or T2D. METHODS: Non-diabetic FDR (n = 138, mean age 40.5 ± 6.5 years, 57 % women) underwent an extended OGTT every 3 years to assess any deterioration in glucose tolerance status. Differences between groups were assessed by logistic fit for continuous variables and by contingency analysis for categorical variables. Multiple logistic regression analysis was applied to adjust for confounding variables. RESULTS: At follow-up (mean 5.6 ± 2.4 years) 19 subjects had IGT and 4 had T2D. At baseline these 23 subjects had more family members with T2D, higher fasting plasma glucose, higher OGTT plasma glucose at 120 min, higher HbA1c, lower M-value and higher total cholesterol compared to subjects with normal glucose tolerance (NGT). There were significantly larger changes in weight, BMI, fasting plasma glucose, OGTT plasma glucose at 120 min and HbA1c in individuals developing IGT or T2D during the follow-up period than the subjects remaining NGT. Crude predictors of deteriorating glucose tolerance were age, family history of diabetes and of hypertension, OGTT plasma glucose levels at 60 min, 90 min, and 120 min, as well as serum bilirubin, ALP and creatinine (p-values <0.05). A multiple nominal logistic regression model revealed that male sex, low M-value and high physical exercise (p-values <0.05) predicted development of IGT/T2DM. CONCLUSION: In sum, genetically predisposed individuals for T2D with deteriorating glucose tolerance exhibit insulin resistance as well as beta-cell and signs of adipose tissue dysfunction, emphasizing the multifactorial pathophysiology in the development of IGT and T2D. BioMed Central 2015-09-25 /pmc/articles/PMC4583989/ /pubmed/26407933 http://dx.doi.org/10.1186/s12902-015-0048-8 Text en © Henninger et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Henninger, Josefin
Hammarstedt, Ann
Rawshani, Araz
Eliasson, Björn
Metabolic predictors of impaired glucose tolerance and type 2 diabetes in a predisposed population – A prospective cohort study
title Metabolic predictors of impaired glucose tolerance and type 2 diabetes in a predisposed population – A prospective cohort study
title_full Metabolic predictors of impaired glucose tolerance and type 2 diabetes in a predisposed population – A prospective cohort study
title_fullStr Metabolic predictors of impaired glucose tolerance and type 2 diabetes in a predisposed population – A prospective cohort study
title_full_unstemmed Metabolic predictors of impaired glucose tolerance and type 2 diabetes in a predisposed population – A prospective cohort study
title_short Metabolic predictors of impaired glucose tolerance and type 2 diabetes in a predisposed population – A prospective cohort study
title_sort metabolic predictors of impaired glucose tolerance and type 2 diabetes in a predisposed population – a prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583989/
https://www.ncbi.nlm.nih.gov/pubmed/26407933
http://dx.doi.org/10.1186/s12902-015-0048-8
work_keys_str_mv AT henningerjosefin metabolicpredictorsofimpairedglucosetoleranceandtype2diabetesinapredisposedpopulationaprospectivecohortstudy
AT hammarstedtann metabolicpredictorsofimpairedglucosetoleranceandtype2diabetesinapredisposedpopulationaprospectivecohortstudy
AT rawshaniaraz metabolicpredictorsofimpairedglucosetoleranceandtype2diabetesinapredisposedpopulationaprospectivecohortstudy
AT eliassonbjorn metabolicpredictorsofimpairedglucosetoleranceandtype2diabetesinapredisposedpopulationaprospectivecohortstudy