Severity of the metabolic syndrome as a predictor of prediabetes and type 2 diabetes in first degree relatives of type 2 diabetic patients:A 15-year prospective cohort study

BACKGROUND Type 2 diabetes mellitus(T2DM)has high morbidity and mortality worldwide,therefore there is of paramount importance to identify the risk factors in the populations at risk early in the course of illness.A strong correlation between severity of metabolic syndrome(MetS)and HbA1c,fasting insulin and insulin resistance has been reported.Accordingly,the MetS severity score(or MestS Zscore)can potentially be used to predict the risk of T2DM progression over time.AIM To evaluate the association the of MestS Z-score in first degree relatives(FDRs)of T2DM with the risk of prediabetes and type 2 diabetes in future.METHODS A prospective open cohort study was conducted between 2003-2018.At baseline,the sample comprised of 1766 FDRs of patients with T2DM who had a normal glucose tolerance test.Relative risk(RR)and 95%confidence interval were calculated based on logistic regression.The receiver-operator characteristic analysis and area under the curve based on MetS Z-score were used to evaluate the risk of prediabetes and diabetes among the FDR population.RESULTS Baseline MetS Z-scores were associated with the its latest values(P<0.0001).Compared with individuals who were T2DM free at the end of follow up,those who developed T2DM had higher MetS Z-score at baseline(P<0.001).In multivariable logistic regression analyses for every unit elevation in MetS Z-score at the baseline,the RR for developing future T2DM and prediabetes was(RR=1.94,RR=3.84),(RR=1.5,RR=2.17)in total population and female group,respectively(P<0.05).The associations remained significant after adjusting the potential confounding variables.A cut off value of 0.97 and 0.94 was defined in the receiver-operator characteristic curve based on the MetS Z-score for differentiating female patients with diabetes and prediabetes from the normal population,respectively.CONCLUSION The MetS Z-score was associated with an increased risk of future T2DM.Appropriate interventions at earlier stages for preventing and attenuating MetS effects may be considered as an effective strategy for FDR as at-risk population.

Thyroid dysfunction and developmental anomalies in first degree relatives of children with thyroid dysgenesis

Background: Familial clustering in patients withpermanent congenital hypothyroidism (CH) caused bythyroid dysgenesis (TD) has been reported in developedcountries. There is no information on familial TD fromdeveloping countries.Methods: A total of 312 first degree relativesbelonging to 80 families of children with TD (group 1)and 40 families of age-matched normal children (group2) were screened by thyroid ultrasonography, serum totalthyroxine (T4) and thyroid stimulating hormone (TSH).Results: Thyroid scintigraphy revealed agenesis in78.7% of the patients, ectopic gland in 15%, and hypoplasiain 6.2%. The mean thyroid volumes were similar in parentsand siblings of both groups. Eight (10.6%) mothers in group1 were identified to have thyroid hypoplasia as comparedwith none in group 2 (P=0.03). Serum TSH was signifi cantlyhigher in group 1 than in group 2 (P=0.004). Sixteen (7.8%)subjects (6 mothers, 5 fathers, and 5 siblings) in group 1were found to have subclinical hypothyroidism as comparedto none in group 2 (P<0.05). Four families were identifiedto have thyroid developmental anomalies and abnormalthyroid functions accounting for 5% of cases of familial TDin our cohort.Conclusions: Thyroid developmental anomalies andthyroid function abnormalities are more frequent in firstdegree relatives of children with TD as compared with acontrol population. These findings suggest that possiblythere is a genetic component of TD in Indian patients.

Cognitive function in ultra high-risk subjects and first degree relatives with schizophrenia

Objective To explore the characteristics of cognitive impariment in ultra high-risk subjects and familial high risk group with schizophrenia.Methods The cognitive function was assessed by the Trail Marking Test,Symbol Coding(SC),Hopkins Verbal Learning Test-Revised(HVLT-R),Brief Visual spatial Memory