Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.
Can J Diabetes. 2013 Apr;37(2):65-71. doi: 10.1016/j.jcjd.2012.12.001. Epub 2013 Apr 23.
To study joint effect of family history of diabetes (FHD) with obesity on prevalence of type 2 diabetes mellitus in the Chinese and in the Finns.
A total of 1091 Chinese men and 1706 women, 1472 Finnish men and 1694 women, 45-74 years of age were studied. The probability and odds ratio (OR) of having diabetes were estimated using logistic regression analysis. The synergy index (SI) and relative excess risk due to interaction (RERI) of FHD with body mass index (BMI) or waist circumference (WC) was calculated.
Age-standardized prevalence of diabetes was higher in individuals with FHD than in those without in both the Chinese and Finns. Compared with individuals without FHD and with BMI <30 kg/m(2), ORs (95% confidence intervals [CI]) for diabetes were 2.7 (1.8, 4.0), 2.8 (1.9, 4.0), 9.1 (5.9, 13.9), respectively, in Finnish men with BMI ≥30 kg/m(2) alone, with FHD alone and with both (SI [95% CI] = 2.4 [1.4, 3.9], RERI = 4.6 [1.3, 8.0]); the corresponding figures were 1.7 (1.0, 2.9), 2.7 (1.8, 4.2) and 4.4 (1.9, 10.4) in Chinese men (SI = 1.4 [0.4, 4.9] RERI = 1.0 [-2.9, 5.0]). They were 3.5 (2.1, 5.8), 2.1 (1.3, 3.4) and 6.8 (4.1, 11.2) in Finnish women (SI = 1.6 [0.9, 2.8], RERI = 2.2 [-0.4, 4.9]), and 1.6 (1.1, 2.2), 2.1 (1.5, 3.0), 3.5 (1.9, 6.4) in Chinese women (SI = 1.5 [0.6, 3.8], RERI = 0.8 [-1.4, 3.0]). The pattern of synergistic effect of FHD with WC on diabetes was similar to that seen with BMI in the Finns but no effect was seen in the Chinese.
Both obesity and FHD are independent risk factors for diabetes, but their joint effect is significant only in Finnish men.
研究家族糖尿病史（FHD）与肥胖对中国和芬兰人群 2 型糖尿病患病率的联合影响。
共纳入 1091 名中国男性和 1706 名中国女性、1472 名芬兰男性和 1694 名芬兰女性，年龄 45-74 岁。采用 logistic 回归分析估计糖尿病的概率和比值比（OR）。计算 FHD 与体重指数（BMI）或腰围（WC）的协同指数（SI）和交互引起的超额相对风险（RERI）。
与无 FHD 且 BMI<30kg/m²的个体相比，芬兰男性中 BMI≥30kg/m² 单独、FHD 单独和两者均有的个体，糖尿病的 OR（95%置信区间[CI]）分别为 2.7（1.8，4.0）、2.8（1.9，4.0）、9.1（5.9，13.9）；相应的数字在芬兰女性中为 3.5（2.1，5.8）、2.1（1.3，3.4）和 6.8（4.1，11.2）；在中国人中为 1.7（1.0，2.9）、2.7（1.8，4.2）和 4.4（1.9，10.4）。FHD 与 WC 对糖尿病的协同作用模式与芬兰人群中 BMI 相似，但在中国人群中未见这种效应。
肥胖和 FHD 都是糖尿病的独立危险因素，但两者的联合作用仅在芬兰男性中显著。
