Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2013 Apr 22;8(4):e61763. doi: 10.1371/journal.pone.0061763. Print 2013.
Interactions between genetic- and lifestyle factors may be of specific importance for the development of type 2 diabetes. Only a few earlier studies have evaluated interaction effects for the combination of family history of diabetes and presence of risk factors related to lifestyle. We explored whether 60-year-old men and women from Stockholm with a parental history of diabetes are more susceptible than their counterparts without a parental history of diabetes to the negative influence from physical inactivity, overweight or smoking regarding risk of developing type 2 diabetes. The study comprised 4232 participants of which 205 men and 113 women had diabetes (the vast majority type 2 diabetes considering the age of study participants) and 224 men and 115 women had prediabetes (fasting glucose 6.1-6.9 mmol/l). Prevalence odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using logistic regression. Biologic interaction was analyzed using a Synergy index (S) score. The crude OR for type 2 diabetes associated with a parental history of diabetes was 2.4 (95% CI 1.7-3.5) in men and 1.4 (95% CI 0.9-2.3) in women. Adjustments for overweight, physical inactivity and current smoking had minimal effects on the association observed in men whereas in women it attenuated results. In men, but not in women, a significant interaction effect that synergistically increases the risk of developing type 2 diabetes was observed for the combination of BMI>30 and a parental history of diabetes, S 2.4 (95% CI 1.1-5.1). No signs of interactions were noted for a parental history of diabetes combined with physical inactivity and smoking, respectively. In conclusion, obesity in combination with presence of a parental history of diabetes may be particularly hazardous in men as these two factors were observed to synergistically increase the risk of developing type 2 diabetes in men.
遗传和生活方式因素之间的相互作用可能对 2 型糖尿病的发生具有特殊意义。以前只有少数研究评估了糖尿病家族史和与生活方式相关的危险因素并存时的相互作用效应。我们探讨了来自斯德哥尔摩的 60 岁男性和女性，如果父母一方患有糖尿病，他们是否比没有这种家族史的人更容易受到身体活动不足、超重或吸烟等因素的负面影响，从而增加患 2 型糖尿病的风险。该研究纳入了 4232 名参与者，其中 205 名男性和 113 名女性患有糖尿病（绝大多数为研究参与者年龄的 2 型糖尿病），224 名男性和 115 名女性患有糖尿病前期（空腹血糖 6.1-6.9mmol/l）。使用逻辑回归计算了具有 95%置信区间（95%CI）的患病比值比（OR）。使用协同指数（S）评分分析生物学相互作用。有糖尿病家族史的男性患 2 型糖尿病的粗 OR 为 2.4（95%CI 1.7-3.5），女性为 1.4（95%CI 0.9-2.3）。在男性中，超重、身体活动不足和当前吸烟的调整对观察到的相关性影响不大，而在女性中，结果减弱。在男性中，但不是在女性中，观察到 BMI>30 和糖尿病家族史的组合存在显著的相互作用效应，协同增加患 2 型糖尿病的风险，S 为 2.4（95%CI 1.1-5.1）。未观察到糖尿病家族史与身体活动不足和吸烟分别结合的相互作用迹象。总之，肥胖症与糖尿病家族史并存可能对男性尤其危险，因为这两个因素被观察到协同增加男性患 2 型糖尿病的风险。
