Hyperinsulinemia cluster predicts the development of type 2 diabetes independently of family history of diabetes

OBJECTIVE - The aim of this prospective study was to determine risk factor clusters predicting type 2 diabetes in subjects with and without family his tory of diabetes by applying factor analyses. RESEARCH DESIGN AND METHODS - The study population consisted of 309 sibling s of diabetic (DM+) or nondiabetic (DM-) probands. Risk factors, including lipids, lipoproteins, blood pressure, and glucose tolerance status, were me asured at the baseline study and 8 years later. RESULTS - siblings in the DM+ group had a significantly higher risk of diab etes (odds ratio [OR] = 3.25; P = 0.002) than siblings in the DM- group. Al together, factor analyses revealed four significant factors in both the DM and DM- groups (the percentage of cumulative variance explained 62-66%). O f these, factor 1 (percentage of variance, 27-29%) was characterized by hig h loadings for BMI, hypertension, glucose area, insulin area (the highest l oading), and triglycerides in both the DM+ and DM- groups, therefore, facto r 1 can be interpreted as a hyperinsulinemia factor. Also, other factors we re essentially similar in both groups. Hyperinsulinemia factor was similarl y associated with thr risk of developing diabetes in the DM+ group (OR = 4. 33, 95% CI 2.29-8.19; P < 0.001) and the DM- group (OR = 4.22, 95% CI 2.02- 8.81; P < 0.001) in logistic regression analyses. CONCLUSIONS - Our results indicate that a cluster of cardiovascular risk fa ctors around hyperinsulinemia is an important predictor of diabetes in 8-ye ar follow-up independent of family history of diabetes.