Effect of family history of type-2 diabetes on coronary flow reserve and it's relationship with insulin resistance: an observational study.

Calışkan M, Pamuk BO, Güllü H, Ciftçi O, Calışkan Z, Erdoğan D, Güven A, Polat E, Müderrisoğlu H.

Source

Department of Cardiology Faculty of Medicine, Başkent University, Ankara-Turkey. caliskandr46@yahoo.com.

Abstract

OBJECTIVE:

Coronary microvascular function among offspring of patients with diabetes mellitus might be compromised when compared to persons with no first-degree relative with diabetes mellitus. The aim of the study was to evaluate effect of family history of type-2 diabetes on coronary flow reserve.

METHODS:

In this observational study, we evaluated coronary flow reserve (CFR) via echocardiography of 95 subjects having a biological parent with type-2 diabetes and 34 healthy volunteers without any biological parent with type-2 diabetes. We have analyzed possible association with CFR and homeostasis model assessment - insulin resistance (HOMA-IR). Comparison analyses were made using independent samples t test, Chi-square test and one-way ANOVA. Association of independent variables with CFR was obtained by correlation analysis and stepwise linear regression model including potential confounders.

RESULTS:

CFR was significantly lower in the positive family history group than in the controls. Moreover, when compared with controls, the subgroup of insulin-sensitive subjects in the positive family history group also had significantly reduced CFR (2.67±0.28 vs. 2.83±0.19; p=0.01). Correlation analysis revealed that CFR was inversely correlated with HOMA-IR, (r=-0.433), fasting glucose (r=-0.331), fasting insulin (r=-0.396), and hemoglobin (Hb)A1c (r=-0.405). When the positive family history group was divided into tertiles of insulin resistance (HOMA-IR <1 .3=".3" 1.3-2.6="1.3-2.6" and="and">2.6; Groups 1-2, and 3), there was a significant difference in CFR between Groups 1 and 2 and between Groups 1 and 3 (p<0 -0.019="-0.019" -0.061="-0.061" .05=".05" 2="2" 3.="3." 95="95" a="a" all="all" also="also" and="and" between="between" cfr="cfr" ci:="ci:" difference="difference" fasting="fasting" for="for" glucose="glucose" groups="groups" in="in" independent="independent" level="level" linear="linear" model="model" not="not" of="of" only="only" p="p" predictor="predictor" regression="regression" significant="significant" statistically="statistically" there="there" though="though" value="0.001," was="was">