Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong.
Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong.
Diabet Med. 2017 Dec;34(12):1701-1709. doi: 10.1111/dme.13516. Epub 2017 Oct 14.
Family history of diabetes is an established risk factor for Type 2 diabetes, but the impact of a family history of young-onset diabetes (onset < 40 years) on future risk of diabetes among first-degree relatives is unclear. In this prospective study, we examined the influence of family history of late- versus young-onset diabetes on the development of diabetes in a young to middle-aged Chinese population.
Some 365 siblings identified through probands with Type 2 diabetes and 452 participants from a community-based health awareness project (aged 18-55 years) who underwent metabolic assessment during the period 1998-2002 were followed to 2012-2013 to determine their glycaemic status. Multivariate logistic regression was performed to investigate the association of family history of diabetes presented at different age categories with development of diabetes.
In this cohort, 53.4% (n = 167) of participants with a family history of young-onset diabetes, 30.1% (n = 68) of those with a family history of late-onset diabetes and 14.4% (n = 40) of those without a family history developed diabetes. Using logistic regression, family history of diabetes presented at ages ≥ 50, 40-49, 30-39 and < 30 years, increased conversion to diabetes with respective odds ratios of 2.4, 5.8, 9.4 and 7.0 (P < 0.001 for all), after adjustment for socio-economic status, smoking, obesity, hypertension and dyslipidaemia. Among participants without diabetes at baseline, risk association of family history of late-onset diabetes with incident diabetes was not sustained, whereas that of family history of young-onset diabetes remained robust on further adjustment for baseline glycaemic measurements.
First-degree relatives of people with Type 2 diabetes, especially relatives of those with young-onset diabetes, are at high risk for diabetes.
糖尿病家族史是 2 型糖尿病的既定危险因素，但家族中有早发糖尿病（发病年龄<40 岁）病史对一级亲属未来患糖尿病的风险影响尚不清楚。在这项前瞻性研究中，我们研究了家族中有晚发与早发糖尿病史对中国年轻到中年人群发生糖尿病的影响。
通过对 2 型糖尿病患者的一级亲属进行调查，共发现 365 名兄弟姐妹，同时纳入了一项社区健康意识项目的 452 名参与者（年龄 18-55 岁），这些参与者在 1998-2002 年期间进行了代谢评估，随访至 2012-2013 年，以确定他们的血糖状态。采用多变量 logistic 回归分析研究不同年龄段的糖尿病家族史与糖尿病发病的关系。
在该队列中，有 53.4%（n=167）的有早发糖尿病家族史的参与者、30.1%（n=68）的有晚发糖尿病家族史的参与者和 14.4%（n=40）的无家族史的参与者发展为糖尿病。采用 logistic 回归分析，校正社会经济地位、吸烟、肥胖、高血压和血脂异常等因素后，年龄≥50、40-49、30-39 和<30 岁时的糖尿病家族史，与糖尿病转化的比值比分别为 2.4、5.8、9.4 和 7.0（均 P<0.001）。在基线时无糖尿病的参与者中，晚发糖尿病家族史与新发糖尿病的风险关联不再持续，而早发糖尿病家族史的风险关联在进一步校正基线血糖测量值后仍然稳健。
2 型糖尿病患者的一级亲属，尤其是早发糖尿病亲属，患糖尿病的风险较高。
