Tuomilehto J, Podar T, Tuomilehto-Wolf E, Virtala E
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
Diabetologia. 1995 Aug;38(8):975-82. doi: 10.1007/BF00400588.
The risk of developing diabetes is higher in offspring of fathers than of mothers with insulin-dependent diabetes mellitus (IDDM). The reasons for this sex differential are unclear, as early studies were often selected and relatively small. We conducted a prospective study on the risk of IDDM in a cohort of 9,453 offspring from 5,255 Finnish parents with diabetes diagnosed before age 30 years. Age of first admission to the hospital was considered to be the age of diagnosis of IDDM in the offspring; IDDM occurred in 248 offspring. The risk of IDDM tended to be lower in the offspring of the same gender as the diabetic parent (adjusted risk ratio (RR) 0.78; p = 0.50). When offspring were of same gender as the diabetic parent, male offspring had a higher risk of IDDM than female offspring (RR 2.28; 95% confidence interval 1.53-3.38), whereas if the gender of the diabetic parent and the offspring were different, the risk in male offspring was lower (RR 0.43; 95% confidence interval 0.31-0.62). For the offspring of diabetic fathers, the cumulative risk by the age of 20 was higher (7.6%) than for those with diabetic mothers (3.5%) (p < 0.0001). In a multivariate analysis statistically significant predictors of IDDM in the offspring were the sex of the parent, the year of birth and the birth order of the offspring. The risk of IDDM in the offspring increased by 9% per year of birth cohort. By age 20, the cumulative risk of developing IDDM in the offspring of diabetic parents was 5.3%, 10 times higher than in the background population. It is likely that genetic factors seem to have played a major role in the continuous increase of IDDM incidence in Finnish children.
患有胰岛素依赖型糖尿病（IDDM）的父亲的后代患糖尿病的风险高于母亲的后代。这种性别差异的原因尚不清楚，因为早期研究往往存在选择性且规模相对较小。我们对来自5255名30岁前被诊断出患有糖尿病的芬兰父母的9453名后代进行了一项关于IDDM风险的前瞻性研究。首次入院年龄被视为后代IDDM的诊断年龄；248名后代发生了IDDM。与糖尿病父母性别相同的后代患IDDM的风险往往较低（调整风险比（RR）为0.78；p = 0.50）。当后代与糖尿病父母性别相同时，男性后代患IDDM的风险高于女性后代（RR为2.28；95%置信区间为1.53 - 3.38），而如果糖尿病父母与后代性别不同，男性后代的风险较低（RR为0.43；95%置信区间为0.31 - 0.62）。对于患有糖尿病父亲的后代，20岁时的累积风险（7.6%）高于患有糖尿病母亲的后代（3.5%）（p < 0.0001）。在多变量分析中，后代患IDDM的统计学显著预测因素是父母的性别、出生年份和后代的出生顺序。后代患IDDM的风险随出生队列年份每年增加9%。到20岁时，糖尿病父母的后代患IDDM的累积风险为5.3%，比背景人群高10倍。遗传因素似乎很可能在芬兰儿童IDDM发病率的持续上升中起了主要作用。
