title: Hyperinsulinemia cluster predicts the development of type 2 diabetes independently of family history of diabetes.
abstract: OBJECTIVE
  The aim of this prospective study was to determine risk factor clusters predicting type 2 diabetes in subjects with and without family history of diabetes by applying factor analyses.
  
  
  METHODS
  The study population consisted of 309 siblings of diabetic (DM+) or nondiabetic (DM-) probands. Risk factors, including lipids, lipoproteins, blood pressure, and glucose tolerance status, were measured at the baseline study and 8 years later.
  
  
  RESULTS
  Siblings in the DM+ group had a significantly higher risk of diabetes (odds ratio [OR] = 3.25; P = 0.002) than siblings in the DM- group. Altogether, factor analyses revealed four significant factors in both the DM+ and DM- groups (the percentage of cumulative variance explained 62-66%). Of these, factor 1 (percentage of variance, 27-29%) was characterized by high loadings for BMI, hypertension, glucose area, insulin area (the highest loading), and triglycerides in both the DM+ and DM- groups; therefore, factor 1 can be interpreted as a hyperinsulinemia factor. Also, other factors were essentially similar in both groups. Hyperinsulinemia factor was similarly associated with the risk of developing diabetes in the DM+ group (OR = 4.33, 95% CI 2.29-8.19; P < 0.001) and the DM- group (OR = 4.22, 95% CI 2.02-8.81; P < 0.001) in logistic regression analyses.
  
  
  CONCLUSIONS
  Our results indicate that a cluster of cardiovascular risk factors around hyperinsulinemia is an important predictor of diabetes in 8-year follow-up independent of family history of diabetes.
authors.affiliation: Department of Medicine, Kuopio University Hospital, Finland. pkekalai@messi.uku.fi
authors.forename: P
authors.initials: P
authors.lastname: Kekäläinen
authors.forename: H
authors.initials: H
authors.lastname: Sarlund
authors.forename: K
authors.initials: K
authors.lastname: Pyörälä
authors.forename: M
authors.initials: M
authors.lastname: Laakso
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D016000:Cluster Analysis; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000235:genetics*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism; D006973:Hypertension / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D009679:Nuclear Family; D011237:Predictive Value of Tests; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D008055:Lipids; D008074:Lipoproteins