Limits...
Increased risk of type 2 diabetes in elderly twins.

Poulsen P, Grunnet LG, Pilgaard K, Storgaard H, Alibegovic A, Sonne MP, Carstensen B, Beck-Nielsen H, Vaag A - Diabetes (2009)

Bottom Line: LBW is common among twins.Twin status per se is associated with abdominal obesity, insulin resistance, and increased prevalence of type 2 diabetes in elderly twins.The data support a quantitatively significant impact of the fetal environment as opposed to genetics on risk of type 2 diabetes.

View Article: PubMed Central - PubMed

Affiliation: Steno Diabetes Center, Gentofte, Denmark. pepn@novonordisk.com

ABSTRACT

Objective: Genetic susceptibility, low birth weight (LBW), and aging are key etiological factors in the development of type 2 diabetes. LBW is common among twins. It is unknown whether twin status per se is associated with risk of type 2 diabetes, and valid concordance rates of type 2 diabetes in twins on a lifetime perspective are lacking.

Research design and methods: A clinical study was done on a population-based cohort of same-sex elderly monozygotic (MZ) and dizygotic (DZ) twins (n = 297) and singleton control subjects (C) (n = 71) including measures of anthropometry and glucose tolerance. In addition, type 2 diabetes incidence cases in twins (n = 626) and singletons (n = 553) were identified through the National Diabetes Register.

Results: Twins were more abdominally obese, insulin resistant, and glucose intolerant, as evidenced by a higher A1C (%) (means +/- SD) (MZ: 6.0 +/- 1.0, DZ: 5.8 +/- 0.7, C: 5.6 +/- 0.3, P = 0.004) and 120-min post-oral glucose tolerance test plasma glucose levels (in mmol/l) (MZ: 8.6 +/- 4.6, DZ: 8.4 +/- 3.9, C: 6.8 +/- 2.4, P = 0.003) compared with singletons. Importantly, twins had a higher prevalence of type 2 diabetes (MZ: 17.5% [95% CI 14.4-20.6], DZ: 15.7% [13.1-18.3], C: 5.6% [3.0-8.2], P = 0.03) together with a 60% higher incidence rate of type 2 diabetes compared with singletons. Cumulative concordance rates of type 2 diabetes to the age of 84 years were similar among elderly MZ (0.76 [0.68-0.84]) and DZ (0.71 [0.63-0.78]) twins.

Conclusions: Twin status per se is associated with abdominal obesity, insulin resistance, and increased prevalence of type 2 diabetes in elderly twins. The data support a quantitatively significant impact of the fetal environment as opposed to genetics on risk of type 2 diabetes.

Show MeSH

Related in: MedlinePlus

Plasma glucose (A), insulin (B), and C-peptide (C) concentrations during an OGTT in elderly MZ and DZ twins and singletons included in the follow-up study. Data are presented as means ± SD. *P < 0.05, **P < 0.01, ***P < 0.001 twins vs. singleton.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2682675&req=5

Figure 2: Plasma glucose (A), insulin (B), and C-peptide (C) concentrations during an OGTT in elderly MZ and DZ twins and singletons included in the follow-up study. Data are presented as means ± SD. *P < 0.05, **P < 0.01, ***P < 0.001 twins vs. singleton.

Mentions: A total of 71 singletons were included as control subjects in the 2005 follow-up study. The singleton control subjects were slightly younger than the twins (P = 0.004), and the distribution of sex differed significantly between the groups of singletons and twins (P = 0.006). Therefore, adjustments were performed for sex and age in the subsequent analyses. Adult height, weight, and BMI were similar in twins and singletons, whereas twins were significantly more abdominally obese with a higher WHR than singletons (P = 0.02) (Table 2). Plasma glucose levels during the OGTT were similar in MZ and DZ twins, whereas post-OGTT plasma glucose levels at time points 30 (P = 0.05), 60 (P = 0.04), and 120 (P = 0.004) min were significantly higher in twins than in singletons (Fig. 2A), as were the incremental AUCglucose levels during the initial 30 min and the total 120 min of the OGTT. Accordingly, A1C concentration was higher (P = 0.004) in twins than singletons, and most importantly, the prevalence of type 2 diabetes was higher in twins than in singletons (MZ: 17.5%; DZ: 15.7%; singletons: 5.6%, P = 0.03), whereas the prevalence of IGT was similar (MZ: 27.8%; DZ: 25.0%; singletons: 22.5%).


Increased risk of type 2 diabetes in elderly twins.

Poulsen P, Grunnet LG, Pilgaard K, Storgaard H, Alibegovic A, Sonne MP, Carstensen B, Beck-Nielsen H, Vaag A - Diabetes (2009)

Plasma glucose (A), insulin (B), and C-peptide (C) concentrations during an OGTT in elderly MZ and DZ twins and singletons included in the follow-up study. Data are presented as means ± SD. *P < 0.05, **P < 0.01, ***P < 0.001 twins vs. singleton.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2682675&req=5

Figure 2: Plasma glucose (A), insulin (B), and C-peptide (C) concentrations during an OGTT in elderly MZ and DZ twins and singletons included in the follow-up study. Data are presented as means ± SD. *P < 0.05, **P < 0.01, ***P < 0.001 twins vs. singleton.
Mentions: A total of 71 singletons were included as control subjects in the 2005 follow-up study. The singleton control subjects were slightly younger than the twins (P = 0.004), and the distribution of sex differed significantly between the groups of singletons and twins (P = 0.006). Therefore, adjustments were performed for sex and age in the subsequent analyses. Adult height, weight, and BMI were similar in twins and singletons, whereas twins were significantly more abdominally obese with a higher WHR than singletons (P = 0.02) (Table 2). Plasma glucose levels during the OGTT were similar in MZ and DZ twins, whereas post-OGTT plasma glucose levels at time points 30 (P = 0.05), 60 (P = 0.04), and 120 (P = 0.004) min were significantly higher in twins than in singletons (Fig. 2A), as were the incremental AUCglucose levels during the initial 30 min and the total 120 min of the OGTT. Accordingly, A1C concentration was higher (P = 0.004) in twins than singletons, and most importantly, the prevalence of type 2 diabetes was higher in twins than in singletons (MZ: 17.5%; DZ: 15.7%; singletons: 5.6%, P = 0.03), whereas the prevalence of IGT was similar (MZ: 27.8%; DZ: 25.0%; singletons: 22.5%).

Bottom Line: LBW is common among twins.Twin status per se is associated with abdominal obesity, insulin resistance, and increased prevalence of type 2 diabetes in elderly twins.The data support a quantitatively significant impact of the fetal environment as opposed to genetics on risk of type 2 diabetes.

View Article: PubMed Central - PubMed

Affiliation: Steno Diabetes Center, Gentofte, Denmark. pepn@novonordisk.com

ABSTRACT

Objective: Genetic susceptibility, low birth weight (LBW), and aging are key etiological factors in the development of type 2 diabetes. LBW is common among twins. It is unknown whether twin status per se is associated with risk of type 2 diabetes, and valid concordance rates of type 2 diabetes in twins on a lifetime perspective are lacking.

Research design and methods: A clinical study was done on a population-based cohort of same-sex elderly monozygotic (MZ) and dizygotic (DZ) twins (n = 297) and singleton control subjects (C) (n = 71) including measures of anthropometry and glucose tolerance. In addition, type 2 diabetes incidence cases in twins (n = 626) and singletons (n = 553) were identified through the National Diabetes Register.

Results: Twins were more abdominally obese, insulin resistant, and glucose intolerant, as evidenced by a higher A1C (%) (means +/- SD) (MZ: 6.0 +/- 1.0, DZ: 5.8 +/- 0.7, C: 5.6 +/- 0.3, P = 0.004) and 120-min post-oral glucose tolerance test plasma glucose levels (in mmol/l) (MZ: 8.6 +/- 4.6, DZ: 8.4 +/- 3.9, C: 6.8 +/- 2.4, P = 0.003) compared with singletons. Importantly, twins had a higher prevalence of type 2 diabetes (MZ: 17.5% [95% CI 14.4-20.6], DZ: 15.7% [13.1-18.3], C: 5.6% [3.0-8.2], P = 0.03) together with a 60% higher incidence rate of type 2 diabetes compared with singletons. Cumulative concordance rates of type 2 diabetes to the age of 84 years were similar among elderly MZ (0.76 [0.68-0.84]) and DZ (0.71 [0.63-0.78]) twins.

Conclusions: Twin status per se is associated with abdominal obesity, insulin resistance, and increased prevalence of type 2 diabetes in elderly twins. The data support a quantitatively significant impact of the fetal environment as opposed to genetics on risk of type 2 diabetes.

Show MeSH
Related in: MedlinePlus