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© 1996 Oxford University Press

research-article

Characteristics of Non-Insulin-Dependent Diabetes Mellitus in Elderly Men: Effect Modification by Family History

JOLANDA M A BOER*,**, EDITH J M FESKENS* and DAAN KROMHOUT{dagger}

* Department of Chronic Disease and Environmental Epidemiology. National Institute of Public Health and Environmental Protection PO Box 1, NL-3720 BA Bilthoven, The Netherlands.
** Department of Epidemiology and Public Health, Wageningen Agricultural University Wageningen, The Netherlands.
{dagger} Division of Public Health Research, National Institute of Public Health and Environmental Protection Bilthoven, The Netherlands.

BACKGROUND: Heredity, obesity and fat distribution may interact with each other in their association with diabetes risk. Therefore we tried to educidate the role of familial diabetes as effect modifier in the association of obesity, glucose metabolism and lipoproteins with non-insulin-dependent diabetes mellitus.

METHODS: A cross-sectional study was carried out among 468 elderty men. Within strata of family history, men with diabetes and normal glucose tolerance were compared with respect to anthropormetry, characteristica of glucose metabolism and serum lipids.

RESULTS: Of the participants, 14.5% were diabetic. In diabetic men a family history of diabetes occured more often (22.1%) than in men with normal (6.8%, P < 0.001) or impaired glucose tolerance (8.5%). In diabetic men with a family history, the ratio of fasting insulin to glucose and the ratio of areas under the insulin and glucose curves during oral glucose tolerance testing were lower compared to men with normal glucose tolerance. In men without a family history, these differences were smaller (interaction P = 0.06). In diabetic men without a family history, fasting insulin levels were markedly elevated (P < 0.001), whereas in men with a family history there was only a alight elevation. The presence of a family history resulted in more severe deteriorations in lipids, especially in fasting triglycerides (interaction P = 0.0–75). No interaction between indices of obesity and a family history was observed.

CONCLUSIONS: Our findings suggest that elderly diabetic men with a family history of diabetes represent a different subgroup than elderly men without such a history, characterized by larger detenorations in indices for beta-cell function and higher triglyceride levels.

Keywords diabetes mellitus, non-insulin-dependent, family history, glucose tolerance, insulin, lipoprotains, obesity

Revised 1 September 1995


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