title: Impaired glucose homeostasis in non-diabetic Greek hypertensives with diabetes family history. Effect of the obesity status.
abstract: Arterial hypertension (AH) and diabetes mellitus (DM) are established cardiovascular risk factors. Impaired glucose homeostasis (IGH; impaired fasting glucose or/and impaired glucose tolerance) or pre-diabetes, obesity, and DM family history identify individuals at risk for type 2 DM in whom preventive interventions are necessary. The aim of this study was to determine the glycemic profile in non-diabetic Greek adult hypertensive men and women according to DM family history and the obesity status. Diabetes family history, obesity markers (waist-to-hip ratio, WHR; body mass index, BMI), glycemic parameters (fasting and 2-hour post-load plasma glucose, if necessary; glycated hemoglobin, HbA1c; fasting insulin), insulin resistance indices (homeostasis model assessment, HOMA; quantitative insulin sensitivity check index, QUICKI; Bennett; McAuley), and IGH prevalence were determined in a large cohort of 11,540 Greek hypertensives referred to our institutions. Positive DM family history was associated with elevated fasting glucose (98.6 ± 13.1 vs 96.5 ± 12.3 mg/dL), HbA1c (5.58% ± 0.49% vs 5.50% ± 0.46%), fasting insulin (9.74 ± 4.20 vs 9.21 ± 3.63 μU/mL) and HOMA (2.43 ± 1.19 vs 2.24 ± 1.01) values, lower QUICKI (0.342 ± 0.025 vs 0.345 ± 0.023), Bennett (0.285 ± 0.081 vs 0.292 ± 0.078) and McAuley (6.73 ± 3.43 vs 6.95 ± 3.44) values, and higher IGH prevalence (45.3% vs 38.7%); P < .01 for all comparisons. The difference in the prevalence of IGH according to DM family history was significant (P < .01) in both genders and every WHR and BMI subgroup (except for women with BMI <20 kg/m(2)). Non-diabetic hypertensives with positive DM family history present with higher IGH prevalence and worse glycemic indices levels compared with those with negative family history, especially in the higher WHR/BMI subgroups.
authors.affiliation: First Cardiology Department, University of Athens Medical School, Hippokration Hospital, 11527, Athens, Greece.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Vyssoulis
authors.forename: Charalampos I
authors.initials: CI
authors.lastname: Liakos
authors.forename: Eva A
authors.initials: EA
authors.lastname: Karpanou
authors.forename: Athanasios I
authors.initials: AI
authors.lastname: Triantafyllou
authors.forename: Andreas P
authors.initials: AP
authors.lastname: Michaelides
authors.forename: Vanessa E
authors.initials: VE
authors.lastname: Tzamou
authors.forename: Maria I
authors.initials: MI
authors.lastname: Markou
authors.forename: Christodoulos I
authors.initials: CI
authors.lastname: Stefanadis
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000378:metabolism; D005192:Family Health; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology* / Q000378:metabolism; D038321:Glycemic Index / Q000502:physiology; D006115:Greece / Q000453:epidemiology; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000378:metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000378:metabolism; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000378:metabolism; D011236:Prediabetic State / Q000453:epidemiology* / Q000378:metabolism; D015995:Prevalence; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: Arterial hypertension; diabetes family history; impaired glucose homeostasis; obesity; pre-diabetes; type 2 diabetes