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. 2009 Jun;58(6):1350-5.
doi: 10.2337/db08-1714. Epub 2009 Mar 31.

Increased risk of type 2 diabetes in elderly twins

Pernille Poulsen  1 , Louise G Grunnet, Kasper Pilgaard, Heidi Storgaard, Amra Alibegovic, Mette P Sonne, Bendix Carstensen, Henning Beck-Nielsen, Allan Vaag
Affiliations

Increased risk of type 2 diabetes in elderly twins

Pernille Poulsen et al. Diabetes. 2009 Jun.

Abstract

Objective: Genetic susceptibility, low birth weight (LBW), and aging are key etiological factors in the development of type 2 diabetes. LBW is common among twins. It is unknown whether twin status per se is associated with risk of type 2 diabetes, and valid concordance rates of type 2 diabetes in twins on a lifetime perspective are lacking.

Research design and methods: A clinical study was done on a population-based cohort of same-sex elderly monozygotic (MZ) and dizygotic (DZ) twins (n = 297) and singleton control subjects (C) (n = 71) including measures of anthropometry and glucose tolerance. In addition, type 2 diabetes incidence cases in twins (n = 626) and singletons (n = 553) were identified through the National Diabetes Register.

Results: Twins were more abdominally obese, insulin resistant, and glucose intolerant, as evidenced by a higher A1C (%) (means +/- SD) (MZ: 6.0 +/- 1.0, DZ: 5.8 +/- 0.7, C: 5.6 +/- 0.3, P = 0.004) and 120-min post-oral glucose tolerance test plasma glucose levels (in mmol/l) (MZ: 8.6 +/- 4.6, DZ: 8.4 +/- 3.9, C: 6.8 +/- 2.4, P = 0.003) compared with singletons. Importantly, twins had a higher prevalence of type 2 diabetes (MZ: 17.5% [95% CI 14.4-20.6], DZ: 15.7% [13.1-18.3], C: 5.6% [3.0-8.2], P = 0.03) together with a 60% higher incidence rate of type 2 diabetes compared with singletons. Cumulative concordance rates of type 2 diabetes to the age of 84 years were similar among elderly MZ (0.76 [0.68-0.84]) and DZ (0.71 [0.63-0.78]) twins.

Conclusions: Twin status per se is associated with abdominal obesity, insulin resistance, and increased prevalence of type 2 diabetes in elderly twins. The data support a quantitatively significant impact of the fetal environment as opposed to genetics on risk of type 2 diabetes.

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Figures

FIG. 1.
FIG. 1.
Age-related cumulative concordance rates (SE) for type 2 diabetes in MZ and DZ elderly twins.
FIG. 2.
FIG. 2.
Plasma glucose (A), insulin (B), and C-peptide (C) concentrations during an OGTT in elderly MZ and DZ twins and singletons included in the follow-up study. Data are presented as means ± SD. *P < 0.05, **P < 0.01, ***P < 0.001 twins vs. singleton.
See this image and copyright information in PMC

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