Factors associated with prediabetes in adult children of patients with premature coronary heart disease;
the study of families of patients with premature coronary heart disease
MV. Konnov, LM. Dobordzhginidze, AD. Deev, NA. Gratsiansky
Center for Atherosclerosis, Institute Of Physico-Chemical Medicine, Moscow, Russian Federation
Material Members of 210 families: 200 aged 35-63 years (149 [61.8%]) parents-probands with
Background It is especially important to elucidate possible contributors
premature CHD (91.4%) and/or LDL-C ≥3.36 mmol/l aged years ( [65.7% ]),
136 their consorts aged 36-67 years (49 [29.9%]) men)
and 251 their own children aged 16-37 years (129 [51.4%] men)
Children had neither overt vascular disease nor diabetes mellitus (DM).
to prediabetes mellitus (preDM) in adult children of patients
with premature coronary heart disease (CHD)
and/or high low density lipoprotein cholesterol (LDL-C).
Purpose To elucidate associations between impaired fasting glucose (IFG) and/or
impaired glucose tolerance (IGT) in adult children of patients
with premature (onset <55 years, men; <60 years, women) CHD and/or LDL-C
and their own and parental characteristics.
Methods Body mass index (BMI) was calculated as follows: body mass (kg)/height (m 2).
Low density lipoprotein cholesterol was calculated with Friedwald‘s formula.
High BP was defined as arterial prehypertension or hypertension (NHBPEP-4 or JNC-7 criteria
depending on age). For diagnosis of IGT and DM was used oral glucose tolerance test (WHO
criteria). IFG and IGT of children were combined and designated prediabetes mellitus (preDM).
Before logistical regression for reduction of continuous coronary risk factors variability and to
suppress possible outliers the symmetric censoring of 1% of their values was carried out.
Predictors were selected by logistical regression analysis with adjustment for age and sex.
Parameters registered alcohol consumption, tobacco smoking,, oral contraceptive use, height, body mass index, waist circumference, heart rate, systolic and diastolic blood pressure, total and
high density lipoprotein cholesterol, LDL-C, triglycerides, basal serum glucose, IFG, IGT, DM (ADA criteria) arterial prehypertension and hypertension and (in parents) education level and presence of
menstruation
0.8
Results
*IFG criteria basal serum glucose =
≥5.55 mmol/l (100 mg/dl) and <7.0 mmol/l (126 mg/dl)
Adult children
13.1
with IGT – 2/251 (0.8%)
*IGT criteria serum glucose after oral glucose tolerance test =
≥7.8 mmol/l (140 mg/dl) and <11.1mmol/l (200 mg/dl)
with IFG (17/33 [51.5% men]) – 33/251 (13.1%)
*www.diabetes.org (American Heart Association, 2006)
with normal basal glucose and glucose tolerance
86.1
(110/216 [50.9% men]) – 216/251 (86.1%)
Table 1. Results of univariate analysis
Factors related (with p<0.1) to preDM in adult children
OR
95% CI
P
own arterial prehypertension or hypertension
own heart rate, beats per minute
basal glucose of consort - parent, mmol/l
own triglycerides, mmol/l
diastolic BP of consort - parent, mm Hg
metabolic syndrome of consort - parent
alcohol of proband - parent
own waist circumference, cm
height of consort - parent, cm
waist circumference of consort - parent, cm
diabetes mellitus type 2 of proband - parent
basal glucose of proband - parent, mmol/l
diabetes mellitus type 2 of proband - parent and/or
consort - parent
3.02
1.05
2.61
1.61
1.04
2.83
0.57
1.03
1.09
1.03
0.88
1.09
1.78 to 5.12
1.02 to 1.09
1.38 to 4.94
1.06 to 2.43
0.99 to 1.08
0.97 to 8.28
0.32 to 1.03
0.99 to 1.06
0.98 to 1.21
0.99 to 1.07
0.33 to 2.31
0.91 to 1.31
0.0001
0.0025
0.0032
0.0251
0.0535
0.0573
0.0633
0.0863
0.0975
0.0978
0.7895
0.3271
1.12
0.33 to 3.79 0.8579
Table 2. Results of multivariate analysis
Independent predictors of preDM in adult children
OR
own arterial prehypertension or hypertension
top tertile basal glucose of consort - parent (≥5.37 mmol/l) vs 2
bottom tertiles (<5.37 mmol/l)
top tertile own heart rate (≥75 beats per minute) vs bottom tertile
(≤66 beats per minute)
2.95 1.71 to 5.12 0.0001
95% CI
P
5.18 1.72 to 15.6 0.003
3.36 1.25 to 9.02 0.016
Conclusions
In this group of adult children with parental premature CHD and/or high LDL-C:
(1)
preDM was not related to any of studied characteristics of proband - parent;
(2)
own arterial pre- and hypertension and (much weaker) basal glucose of consort parent and own heart rate were the predictors independently and strongly
associated with preDM;
For further information or comments: konnov-mihail@yandex.ru