家族史与 2 型糖尿病风险的关系因种族而异。

The relationship of family history and risk of type 2 diabetes differs by ancestry.

机构信息

The Johns Hopkins GeneSTAR Research Program, Department of Medicine, The Johns Hopkins Medical Institutions, 1830, East Monument Street, Room 8023, 21287 Baltimore, MD, USA.

出版信息

Diabetes Metab. 2019 Jun;45(3):261-267. doi: 10.1016/j.diabet.2018.05.004. Epub 2018 May 21.

DOI:10.1016/j.diabet.2018.05.004

PMID:29875064

Abstract

AIM

Type 2 diabetes (T2DM) in a first-degree relative is a risk factor for incident diabetes. Americans of African ancestry (AA) have higher rates of T2DM than Americans of European ancestry (EA). Thus, we aimed to determine whether the presence, number and kinship of affected relatives are associated with race-specific T2DM incidence in a prospective study of participants from the Genetic Study of Atherosclerosis Risk (GeneSTAR), who underwent baseline screening including a detailed family history.

METHODS

Nondiabetic healthy siblings (n=1405) of patients with early-onset coronary artery disease (18-59 years) were enrolled (861 EA and 544 AA) and followed for incident T2DM (mean 14±6 years).

RESULTS

Baseline age was 46.2±7.3 years and 56% were female. T2DM occurred in 12.3% of EA and 19.1% of AA. Among EA, 32.6% had ≥1 affected first-degree relatives versus 53.1% in AA, P<0.0001. In fully adjusted Cox proportional hazard analyses, any family history was related to incident T2DM in EA (HR=2.53, 95% CI: 1.58-4.06) but not in AA (HR=1.01, 0.67-1.53). The number of affected relatives conferred incremental risk of T2DM in EA with HR=1.82 (1.08-3.06), 4.83 (2.15-10.85) and 8.46 (3.09-23.91) for 1, 2, and ≥3 affected, respectively. In AA only ≥3 affected increased risk (HR=2.45, 1.44-4.19). Specific kinship patterns were associated with incident T2DM in EA but not in AA.

CONCLUSIONS

The presence of any first-degree relative with T2DM does not discriminate risk in AA given the high race-specific prevalence of diabetes. Accounting for the number of affected relatives may more appropriately estimate risk for incident diabetes in both races.

摘要

目的

一级亲属中患有 2 型糖尿病（T2DM）是发生糖尿病的危险因素。非裔美国人（AA）的 T2DM 发病率高于欧洲裔美国人（EA）。因此，我们旨在确定在一项对来自动脉粥样硬化风险的遗传研究（GeneSTAR）的参与者进行的前瞻性研究中，是否存在、数量和亲属关系与特定种族的 T2DM 发病率相关，这些参与者在基线筛查中接受了包括详细家族史在内的检查。

方法

招募了患有早发冠心病（18-59 岁）的患者的非糖尿病健康兄弟姐妹（n=1405）（861 名 EA 和 544 名 AA），并随访了 T2DM 的发病情况（平均随访时间 14±6 年）。

结果

基线年龄为 46.2±7.3 岁，56%为女性。EA 中 T2DM 的发生率为 12.3%，AA 中为 19.1%。在 EA 中，32.6%有≥1 位一级亲属患病，而 AA 中为 53.1%，P<0.0001。在完全调整的 Cox 比例风险分析中，任何家族史与 EA 中 T2DM 的发生相关（HR=2.53，95%CI：1.58-4.06），但在 AA 中不相关（HR=1.01，0.67-1.53）。在 EA 中，受累亲属数量每增加 1 个，T2DM 的发病风险分别增加 1.82（1.08-3.06）、4.83（2.15-10.85）和 8.46（3.09-23.91）；在 AA 中，仅≥3 位受累亲属增加发病风险（HR=2.45，1.44-4.19）。在 EA 中，特定亲属关系模式与 T2DM 的发病相关，但在 AA 中不相关。