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Unfavourable risk factors for type 2 diabetes mellitus are already apparent more than a decade before onset in a population-based study of older persons: from the Age, Gene/Environment Susceptibility—Reykjavik Study (AGES-Reykjavik)

  • Diabetes Mellitus
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Abstract

We evaluated midlife risk factors of developing type 2 diabetes mellitus (T2DM) in late life in a population-based study of older persons. A cohort of 2,251 persons, aged 65–96, participated in AGES-Reykjavik in 2002–2004; all attended the Reykjavik Study 26 years earlier, at the mean age of 50. Based on glucometabolic status in 2002–2004 the participants are divided into a normoglycemic control group (n = 1,695), an impaired fasting glucose (IFG) group (n = 313) and T2DM group (n = 243). Change in risk parameters from midlife is evaluated retrospectively in these three groups. Since examined earlier 14.3% of men and 8.2% of women developed T2DM. A family history of diabetes was reported in 39.5% of T2DM compared to 19.3% in both IFG and normoglycemics. The T2DM and IFG groups currently have higher levels of fasting triglycerides, greater body mass index (BMI) and higher systolic blood pressure than normoglycemics and this difference was already apparent in midlife. In late life, two or more metabolic syndrome criteria are present in 60% of the T2DM groups compared to 25% in normoglycemic groups. T2DM with impaired cardiovascular health is more marked in women than men when compared with normoglycemics. Family history and higher levels of BMI, triglycerides and systolic blood pressure in midlife are associated with the development of T2DM in late life, suggesting risk can be evaluated long before onset. A continued rise in risk factors throughout life allows for more aggressive measures in preventing or delaying development of T2DM and its effect on cardiovascular health.

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Abbreviations

AGES-Reykjavik:

Age, Gene/Environment Susceptibility—Reykjavik Study

BMI:

Body mass index

CE:

Coronary events

CHD:

Coronary heart disease

CRP:

C-reactive protein

CVD:

Cardiovascular disease

ECG:

Electrocardiograph

HbA1c :

Haemoglobin A1c

HOMAIR :

Homeostasis model assessment: insulin resistance

ICD-10:

International Statistical Classification of Diseases and Related Health Problems 10th Revision

IFG:

Impaired fasting glucose

MI:

Myocardial infarction

MS:

Metabolic syndrome

NCEP:

National Cholesterol Education Program

NHANES:

National Health and Nutrition Examination Survey

RS:

Reykjavik Study

SD:

Standard deviation

T2DM:

Type 2 diabetes mellitus

TG:

Triglycerides

WHO:

World Health Organization

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Acknowledgments

The study is supported by National Institutes of Health contract NO1-AG-1-2100, the National Institute on Aging Intramural Research Program, the Icelandic Government and the Icelandic Heart Association.

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Authors and Affiliations

  1. Icelandic Heart Association, Holtasmari 1, 201, Kopavogur, Iceland

    Elin Olafsdottir, Thor Aspelund, Bolli Thorsson, Gudny Eiriksdottir & Vilmundur Gudnason

  2. Medical Faculty, University of Iceland, Reykjavik, Iceland

    Gunnar Sigurdsson, Rafn Benediktsson & Vilmundur Gudnason

  3. Landspitali University Hospital, Reykjavik, Iceland

    Gunnar Sigurdsson & Rafn Benediktsson

  4. Faculty of Science, University of Iceland, Reykjavik, Iceland

    Thor Aspelund

  5. Intramural Research Program, National Institute on Aging, Bethesda, MD, 20892, USA

    Tamara B. Harris & Lenore J. Launer

Authors
  1. Elin Olafsdottir
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  2. Thor Aspelund
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  3. Gunnar Sigurdsson
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  4. Bolli Thorsson
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  5. Rafn Benediktsson
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  6. Tamara B. Harris
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  7. Lenore J. Launer
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  8. Gudny Eiriksdottir
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  9. Vilmundur Gudnason
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Correspondence to Elin Olafsdottir.

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Olafsdottir, E., Aspelund, T., Sigurdsson, G. et al. Unfavourable risk factors for type 2 diabetes mellitus are already apparent more than a decade before onset in a population-based study of older persons: from the Age, Gene/Environment Susceptibility—Reykjavik Study (AGES-Reykjavik). Eur J Epidemiol 24, 307–314 (2009). https://doi.org/10.1007/s10654-009-9343-x

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  • DOI: https://doi.org/10.1007/s10654-009-9343-x

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