Tumour necrosis factor-alpha (TNF-alpha) is considered to be involved in the insulin resistance of type 2 diabetes mellitus. The offspring of patients with type 2 diabetes mellitus are at increased risk of developing diabetes and several metabolic abnormalities, but the underlying defects responsible are not known. We studied serum TNF-alpha levels in 30 healthy non-diabetic offspring of type 2 diabetic parents (group A), and the relationship between TNF-alpha levels and variables associated with insulin resistance and diabetes. For comparison, 30 healthy offspring of non-diabetic parents (group B) were also studied. The median serum concentration of TNF-alpha was significantly higher in group A than in group B, 3.5 pg/ml compared with 2.0 pg/ml, respectively. The individuals of group A also had significantly elevated levels of glycosylated haemoglobin, fasting glucose, glucose 2 h after an oral glucose tolerance test and triglycerides. We conclude that serum TNF-alpha concentration is significantly elevated in non-diabetic offspring of type 2 diabetics and this may predict later impairment of insulin action in these individuals.

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performed by the same operator. 119 pts were men and represent the 54% of pts with HF with pEF and the 71% of pts with HF with rEF. Average age was 70 AE 10 years (28-98) without significative differences in pts with or without pEF. HF ethiopathogenesis was due to hypertension in 95% of pts with pEF and 67% in pts with rEF.Concentric remodelling is the geometric pattern prevalent in pts with pEF whereas eccentric hypertrophy is more common among pts with rEF. If we analyse echocardiographic data in each different geometric pattern group, we find that in pts with normal geometry, DT is significantly reduced if EF<50 (0,22 AE 0,05 vs 0,16 AE 0,06, p < 0.05).We obtained similar results also when using RWT>0.42 as pathologic cut off value.Conclusions: Even if pts with pEF is mostly NYHA 0 or I in comparison to pts with rEF (mostly in NYHA II or III), they came from the same population of pts discharged from hospital with diagnosis of acute HF. These two different kinds of pts show a different echocardiographic geometric pattern.