Is Family History a Useful Tool for Detecting Children at Risk for Diabetes and Cardiovascular Diseases? A Public Health Perspective

Abstract

Several studies indicate that the risk for type 2 diabetes or cardiovascular disease is detectable in childhood, although these disorders may not emerge until adulthood. In addition, type 2 diabetes and cardiovascular disease seem to share risk factors, including obesity and dyslipidemia, and might even share etiology, which has important implications for screening and prevention strategies for both diseases. Primary prevention, in particular, has gained importance because the results of major randomized, controlled trials strongly suggest that, at least in high-risk adult groups, type 2 diabetes can be prevented or delayed. Furthermore, some intervention studies indicate that the risk factors for diabetes and cardiovascular disease can be reduced in children. A simple way to detect risk for either diabetes or cardiovascular disease is to examine the family history. Numerous studies have shown that adults who have 1 or more first-or second-degree relatives affected with diabetes or cardiovascular disease are at high risk of having or developing these diseases. Currently, there are no overall screening strategies recommended for either diabetes or cardiovascular disease among children and adolescents. The evidence is strong, however, that youth with a positive family history already show signs of increased risk for these conditions. Family history can be part of the approach to screening for children at risk of diabetes and cardiovascular disease and should be part of prevention campaigns aimed at reducing the burden of these diseases and their risk factors in children.www.pediatrics.org/cgi

Prevalencia de dislipidemia y sus factores de riesgo en niños y adolescentes con sobrepeso y obesidad

“…Entre ellos se pueden encontrar los antecedentes familiares de dislipidemia e infarto agudo de miocardio (IAM) 2,4,5 , y también la obesidad que, debido a que ha aumentado su frecuencia, se ha constituido en uno de los principales factores de riesgo, tanto en adultos 6,7 como en niños y adolescentes [7][8][9] .…”

Family history of myocardial infarction, stroke and diabetes and cardiometabolic markers in children

“…Although we could not validate reported history of diabetes and CVD with medical records, evidence suggests that family history of diabetes and major CVD events are reported fairly accurately, because they are serious, but not stigmatised, diseases with clear case definitions [3,28]. Family history of diabetes may have been underreported because of under diagnosis [3], which may have led to underestimation of the true association. Mothers of the PIAMA children completed most questionnaires (85%), which is likely to explain the higher number of unknowns and missing reports of disease cases in the fathers' lineage.…”

“…socioeconomic position and health behaviours [1]. The association of cardiovascular disease (CVD) in first-or second-degree relatives with the presence of risk factors for atherosclerosis, such as high cholesterol and BP, in children has been described [2,3]. Other studies showed that familial aggregation of type 2 diabetes also relates to the presence of cardiometabolic abnormalities in children [4][5][6][7][8].…”

“…Other studies showed that familial aggregation of type 2 diabetes also relates to the presence of cardiometabolic abnormalities in children [4][5][6][7][8]. CVD and type 2 diabetes often co-occur [3,9,10] and share risk factors such as hypertension, overweight, unhealthy diet and lack of physical activity. However, previous studies assessing cardiometabolic markers in children lacked data on family history of both CVD and diabetes, and it is unclear whether CVD and diabetes history are independently associated with cardiometabolic markers in children.…”

Hábitos alimentares e fatores de risco para aterosclerose em estudantes de Bento Gonçalves (RS)

“…A simple way to detect any risk for both diseases is to examine the family history. Family history can be part of the approach for screening children at risk of diabetes and cardiovascular disease and its investigation must include campaigns to reduce their risk factors 25 .…”