CARDIOVASCULAR-DISEASE RISK-FACTORS AS PREDICTORS OF TYPE-2 (NON-INSULIN-DEPENDENT) DIABETES-MELLITUS IN ELDERLY SUBJECTS

Risk factors measured in a cross-sectional study in subjects aged 65-7 4 years living in eastern Finland were correlated with the risk of dev eloping diabetes 3.5 years later. Sixty-nine of 892 initially non-diab etic subjects developed diabetes during the follow-up. Subjects who su bsequently developed diabetes had multiple adverse changes in risk fac tor levels before the diagnosis of diabetes. Subjects who developed di abetes had higher body mass index and waist-hip ratio as well as highe r levels of fasting and 2-h plasma glucose and insulin and higher prev alence of family history of diabetes than those who remained healthy. Furthermore, prevalence of hypertension and levels of diastolic blood pressure and total triglycerides were higher and HDL cholesterol lower among subjects who developed diabetes than among those who remained h ealthy. The highest risk of developing diabetes was associated with im paired glucose tolerance (World Health Organisation criteria) (odds ra tio = 9.8,95 % confidence interval = 6.1-5.8). The risk of developing diabetes was 3.7 (3.2-6.1) among subjects in the highest quartile of 2 -h insulin distribution, 3.5 (2.0-6.1) in those with triglycerides gre ater than 2.5 mmol/l, 2.7 (1.5-4.6) in those with waist-hip ratio grea ter than 1.0, 2.5 (1.5-4.4) in those with HDL cholesterol less than 1. 0 mmol/l, 2.1 (1.2-3.6) in those with body mass index greater than 30 kg/m2, 1.9 (1.1-3.3) among those in the highest quartile of fasting in sulin distribution, 1.8 (1.0-3.1) in those having hypertension, and 1. 7 (1.0-2.9) in those with a family history of diabetes. The risk of di abetes increased by clustering of risk factors related to insulin resi stance (impaired glucose tolerance, triglycerides > 2.5 mmol/l, HDL ch olesterol < 1.0, hypertension) so that the risk was 3.6-fold in those having one risk factor and 59-fold in those having all four risk facto rs compared to subjects having no risk factors. In conclusion, cardiov ascular risk factors related to insulin resistance are predictors of d iabetes in the elderly.