Heritability of carotid artery intima-medial thickness in type 2 diabetes
Heritability of carotid artery intima-medial thickness in type 2 diabetes
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DOI：
10.1161/01.str.0000019909.71547.aa
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发表时间：
2002-07-01
期刊：
影响因子：
8.3
通讯作者：
Freedman, BI
中科院分区：
文献类型：
--
作者：
Lange, LA;Bowden, DW;Freedman, BI
背景和目的-颈动脉内膜中层厚度（IMT）是亚临床动脉粥样硬化的标志物，是随后心血管发病的有力预测因子。遗传因素在颈动脉壁增厚中的作用仍然很大程度上未知。我们假设，在有多位糖尿病成员的家庭中，颈动脉 IMT 可能与遗传因素和环境因素有关。 方法 - 为了确定存在 2 型糖尿病的情况下颈动脉 IMT 的家族聚集程度，我们研究了来自 122 个家庭的 252 名 2 型糖尿病患者（平均年龄 60.6 岁）。通过高分辨率 13 模式超声检查测量颈总动脉 IMT。其他测量因素包括血脂水平、体重指数、空腹血糖、血红蛋白 A(1c)、白蛋白/肌酐比和自我报告病史。遗传力估计是通过使用方差分量方法获得的，如 SOLAR 软件包中所实施的。通过使用混合模型分析进行颈动脉 IMT 与变量之间的关联测试，同时考虑家庭结构引起的相关性。结果 - 颈动脉 IMT 的年龄、性别和种族调整遗传力估计值为 0.32（SE 0.17，P=0.02）。对总胆固醇、高血压状况和当前吸烟状况的进一步调整导致遗传力估计值为 0.41（SE 0.16，P=0.004）。调整年龄和性别后，颈动脉 IMT 的最强预测因素是种族（非裔美国人与白人）、总胆固醇和吸烟状况。结论 - 这些数据提供了经验证据，表明亚临床心血管疾病具有显着的遗传成分，值得寻找与糖尿病动脉粥样硬化并发症易感性有关的基因。
Background and Purpose-Carotid artery intima-medial thickness (IMT), a marker of subclinical atherosclerosis, is a strong predictor of subsequent cardiovascular morbidity. The role of genetic factors in thickening of the carotid wall remains largely unknown. We hypothesize that in families with multiple members having diabetes, carotid IMT is likely to be associated with both inherited and environmental factors.Methods-To determine the extent of the familial aggregation of carotid IMT in the presence of type 2 diabetes, we studied 252 individuals with type 2 diabetes (mean age 60.6 years) from 122 families. Common carotid artery IMT was measured by high-resolution 13-mode ultrasonography. Other measured factors included lipid levels, body mass index, fasting glucose, hemoglobin A(1c), albumin/creatinine ratio, and self-reported medical history. Heritability estimates were obtained by using variance component methodology, as implemented in the SOLAR software package. Tests for association between carotid IMT and variables were performed by using mixed model analysis while accounting for the correlation due to family structure.Results-The age-, sex-, and race-adjusted heritability estimate for carotid IMT was 0.32 (SE 0.17, P=0.02). Further adjustment for total cholesterol, hypertension status, and current smoking status resulted in a heritability estimate of 0.41 (SE 0.16, P=0.004). The strongest predictors of carotid IMT, after adjusting for age and sex, were ethnicity (African American versus white), total cholesterol, and smoking status.Conclusions-These data provide empirical evidence that subclinical cardiovascular disease has a significant genetic component and merits a search for the genes involved in susceptibility to the atherosclerotic complications of diabetes.