Subclinical Atherosclerosis in Young Adult Population with First Degree Relatives of Type 2 Diabetes Mellitus.

Cardiovascular disease (CVD) remain a leading cause of death globally. The concept of acute myocardial infarction in young adults was uncommon. Atherosclerosis is the leading cause of CVD, including myocardial infarction, stroke, heart failure and peripheral artery disease. This condition is initiated early in childhood and progressive in nature. CVD risk factors includes hypertension, dyslipidemia and obesity play a role in the development of atherosclerosis and  components in insulin resistance syndrome.One of many risk factors for insulin resistance in healthy individuals is a first-degree relative (FDR) of Type 2 Diabetes Mellitus (T2DM) patients. This group shows a higher risk of insulin resistance and pancreatic beta cells disruption even in adolescence, although they often remains asymptomatic. Clinical manifestations of metabolic disorders and atherosclerosis will appear earlier in the FDR T2DM group who have sedentary lifestyles and obesity, when compared to the non-FDR group. Several studies have attempted to detect metabolic disorders and subclinical atherosclerosis that might occur; therefore an early prevention can be carried out in these high-risk groups.  Unfortunately, factors that affect the onset and the severity of the prospective clinical manifestations from the previous studies remained inconclusive.

Hypercholesterolemia as the first manifestation of metabolic abnormalities in normoglycemic young adult male with family history of type 2 diabetes mellitus.

BACKGROUND: Although several studies reported high number of metabolic disorder among First Degree Relatives (FDR) of Type 2 Diabetes Mellitus (T2DM), only a few studies analyzed the impact of gender on the occurence of metabolic abnormalities. AIMS: This study aimed to investigate the first manifestation of metabolic abnormalities in normoglycemic FDR of T2DM. METHODS AND MATERIALS: This cross-sectional study recruited 60 FDR of T2DM age of 19-39 years old in Jakarta, Indonesia. We matched 60 non-FDR as controls. All participants had neither glucose intolerance nor hypertension. Anthropometry, body composition and laboratory measurements (blood glucose, HbA1c, lipid profile, liver and kidney function test) were assessed. RESULTS: In males, FDR aged 30-39 years old had higher Total Cholesterol (TC) level ([233 ±â€¯51.43 mg/dL vs. 177.83 ±â€¯22.08 mg/dL, p = 0.036] and Low Density Lipoprotein Cholesterol (LDL-C) level [173.83 ±â€¯39.83 mg/dL vs. 125.67 ±â€¯21.50 mg/dL, p = 0.026] than those of non-FDR significantly. FDR also had higher risk of hypercholesterolemia than non-FDR [OR 5.25 (1.09-25.21)]. There were no differences of metabolic abnormalities between female FDR and non-FDR group. CONCLUSION: Male FDR of T2DM showed higher level of TC and LDL-C level than those of non FDR. Male FDR also showed higher risk of dyslipidemia.

Carotid intima-media thickness among normoglycemia and normotension first-degree relatives of type 2 diabetes mellitus.

Introduction: Theoretically, first-degree relatives (FDRs) of type 2 diabetes mellitus (T2DM) are predisposed to have earlier and more severe atherosclerosis than non-FDR due to hereditary insulin resistance. A previous study reported that atherosclerotic plaques were found in 45.2% of young adults FDR of T2DM, but the study did not include non-FDR as control group. The aim of this study was to compare subclinical atherosclerosis (carotid intima-media thickness, CIMT) between FDR of T2DM and non-FDR. Method: This was a cross-sectional study involving 16 FDR subjects and 16 age-sex matched non-FDR subjects, aged 19-40 years, with normal glucose tolerance and no hypertension. Collected data included demographic characteristic, anthropometric measurement (BMI and waist circumference), laboratory analysis (fasting blood glucose, HbA1c, lipid profile), and CIMT examination (using B-mode ultrasound). Results: The mean of CIMT in the FDR group was higher than that in the non-FDR group (0.44 mm vs 0.38 mm, p=0.005). After adjusting for waist circumference, BMI, low-density lipoprotein cholesterol, and triglyceride, CIMT maintained significant difference between FDR and non-FDR subjects. BMI and waist circumference showed moderate correlation with CIMT. Conclusion: CIMT in young adult FDR of T2DM is thicker than that in age-and sex-matched non-FDR population.