The impact of family history of diabetes and lifestyle factors on abnormal glucose regulation in middle-aged Swedish men and women

Abstract

Aims/hypothesis We investigated associations between abnormal glucose regulation and family history of diabetes, separately and in combination with lifestyle risk factors. Subjects and methods This cross-sectional study comprised 3,128 men and 4,821 women, aged 35-56 years, half with a family history of diabetes. Oral glucose tolerance testing identified subjects with previously undiagnosed prediabetes (IFG, IGT) and type 2 diabetes. Information on lifestyle factors was obtained by questionnaire. Biological interaction was measured with the synergy index. Results A family history of diabetes conferred a higher odds ratio (OR) for type 2 diabetes in men (OR=3.1, 95% CI 1.7-5.6) than in women (OR=1.7, 95% CI 1.0-3.0), and the synergy index was 2.8 (95% CI 0.9-9.0), suggesting interaction between a family history of diabetes and sex. For prediabetes and diabetes combined, the synergy index was 1.7 (1.0-2.8). Exposure to only one lifestyle risk factor (obesity, physical inactivity, smoking or low sense of coherence [a psychosocial index]) increased the risk to a similar extent in men and women. Combined exposure to a family history of diabetes and lifestyle-related risk factors had a greater effect on type 2 diabetes than any of these factors alone, especially in men. However, analysis of interaction between a family history of diabetes and the lifestyle factors did not indicate any interaction for diabetes, but did indicate interaction for a family history of diabetes and obesity in women with prediabetes. Conclusions/interpretation Our data suggest a more pronounced effect of a family history of diabetes on the risk of type 2 diabetes in men than in women. While both a family history of diabetes and lifestyle risk factors had effects on type 2 diabetes, irrespective of sex, these effects did not appear to interact.

Family history of diabetes is associated with higher risk for prediabetes: a multicentre analysis from the German Center for Diabetes Research

“…An earlier study from Sweden also found a 50% increased risk of prediabetes in participants with FHD [4]. In our metaanalysis, the OR was lowest for iIGT (1.25) compared with iIFG (1.37) and IFG+IGT (1.64).…”

Offspring of Patients With Diabetes Exhibit a Clustering of Psychosocial Distress and Inflammatory and Metabolic Risk Factors

“…A positive parental history was not associated with sex, ethnicity, fasting glucose, age, C-reactive protein, interleukin-6, anger, depression, or social support. Similar to previous observations, subjects with a family history of diabetes had a higher BMI (4,5) (27 ± 6.6 vs. 24.5 ± 3.8 kg/m 2 , P = 0.07), significantly higher insulin resistance as derived from homeostatis model assessment (5) (median 1.70 [interquartile range 1.19–1.90] vs. 1.30 [0.80–1.82], P = 0.04), and significantly higher fasting plasma insulin (5) (10.3 ± 9 vs. 6.7 ± 4 μU/ml, P = 0.02). However, the relationships of insulin resistance and fasting plasma insulin to parental history were mediated by BMI but not age, ethnicity, or sex.…”

Insulin-like growth factor-binding protein-1 in the prediction and development of type 2 diabetes in middle-aged Swedish men

“…A similar pattern was seen for each group (IFG, IGT, IFG+IGT) when analysed separately. There was no significant change in fasting IGFBP-1 values in the 19 individuals with diabetes diagnosed on the basis of glucose values 2 h after oral glucose (20 μg/l [95% CI [15][16][17][18][19][20][21][22][23][24][25][26][27] and 20 μg/l [95% CI [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] at baseline and follow up, respectively). In those who developed diabetes, fasting IGFBP-1 concentrations were higher at the 10 years followup compared with baseline (paired t tests; Fig.…”

“…Study population The present study was an incident casecontrol study of Swedish white men who were part of a 10 year follow-up epidemiological survey, the Stockholm Diabetes Prevention Program (SDPP), which is described elsewhere [20][21][22]. The SDPP is a population-based study of individuals aged 35-56 years who were without known diabetes at the time of recruitment in 1992-1994.…”

“…In addition to patients with diabetes, individuals with impaired glucose tolerance (IGT) are also at increased risk of micro-and macrovascular disease and premature cardiovascular death [18,19]. We have recently shown that family history of diabetes (FHD) is associated with increased prevalence of abnormal glucose tolerance [20] especially in men [21]. The aim of the present study was to determine IGFBP-1 levels in this population, in order to evaluate their predictive role and change in concentrations during the development of abnormal glucose regulation.…”