The influence of insulin resistance in the occurence of non-alcoholic fatty liver disease among first degree relatives of type 2 diabetes.

BACKGROUND: First degree relatives (FDR) of type 2 diabetes mellitus (T2DM) predisposes individuals to have earlier metabolic and vascular disorders independent of insulin resistance (IR) such as thicker carotid intima media thickness than that of non-FDR. Non-alcoholic fatty liver disease (NAFLD) is the most commonly found chronic liver disease in T2DM which is IR dependent. Studies about NAFLD in FDR of T2DM populations are very limited and inconclusive. It is unclear whether the occurrence of NAFLD in FDR of T2DM is IR dependent or due to genetic vulnerability. AIMS: The aim of this study is to determine the association between NAFLD and FDR of T2DM. METHOD AND MATERIALS: A total of 118 young adults (19-39 years old) with normal glucose tolerance (59 FDR of T2DM and age-sex matched 59 non-FDR subjects) were included in this cross-sectional study. Anthropometric measurement and routine laboratory analysis (fasting blood glucose/FBG, HbA1c, lipid profile, alanine aminotransferase (ALT), aspartate transaminase (AST)) were examined. Fatty liver was diagnosed by ultrasonography (US) using standard criteria. RESULTS: Twenty-six (22,03%) subjects with NAFLD were detected by ultrasound with similar proportion for each group. Low HDL-C level and metabolic syndrome were found higher in FDR group (p = 0.004, OR 3.81, CI95 = 1.47-9,91; p = 0.023, OR 4.28, CI95 = 1.13-16.23). Based on logistic regression analysis, central obesity and obesity had statistically significant influence towards NAFLD. CONCLUSION: The occurrence of NAFLD in FDR of T2DM was influenced by IR (central obesity and obesity).

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.