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Scott, R A; Langenberg, C; Sharp, S J; Franks, P W; Rolandsson, O; Drogan, D; van der Schouw, Y T; Ekelund, U; Kerrison, N D; Ardanaz, E; Arriola, L; Balkau, B; Barricarte, A; Barroso, I; Bendinelli, B; Beulens, J W J; Boeing, H; de Lauzon-Guillain, B; Deloukas, P; Fagherazzi, G; Gonzalez, C; Griffin, S J; Groop, L C; Halkjaer, J; Huerta, J M; Kaaks, R; Khaw, K T; Krogh, V; Nilsson, P M; Norat, T; Overvad, K; Panico, S; Rodriguez-Suarez, L; Romaguera, D; Romieu, I; Sacerdote, C; Sánchez, M J; Spijkerman, A M W; Teucher, B; Tjonneland, A; Tumino, R; van der A, D L; Wark, P A; McCarthy, M I; Riboli, E; Wareham, N J
Diabetologia, 01/2013, Letnik: 56, Številka: 1Journal Article
Aims/hypothesis Although a family history of type 2 diabetes is a strong risk factor for the disease, the factors mediating this excess risk are poorly understood. In the InterAct case-cohort study, we investigated the association between a family history of diabetes among different family members and the incidence of type 2 diabetes, as well as the extent to which genetic, anthropometric and lifestyle risk factors mediated this association. Methods A total of 13,869 individuals (including 6,168 incident cases of type 2 diabetes) had family history data available, and 6,887 individuals had complete data on all mediators. Country-specific Prentice-weighted Cox models were fitted within country, and HRs were combined using random effects meta-analysis. Lifestyle and anthropometric measurements were performed at baseline, and a genetic risk score comprising 35 polymorphisms associated with type 2 diabetes was created. Results A family history of type 2 diabetes was associated with a higher incidence of the condition (HR 2.72, 95% CI 2.48, 2.99). Adjustment for established risk factors including BMI and waist circumference only modestly attenuated this association (HR 2.44, 95% CI 2.03, 2.95); the genetic score alone explained only 2% of the family history-associated risk of type 2 diabetes. The greatest risk of type 2 diabetes was observed in those with a biparental history of type 2 diabetes (HR 5.14, 95% CI 3.74, 7.07) and those whose parents had been diagnosed with diabetes at a younger age (<50 years; HR 4.69, 95% CI 3.35, 6.58), an effect largely confined to a maternal family history. Conclusions/interpretation Prominent lifestyle, anthropometric and genetic risk factors explained only a marginal proportion of the excess risk associated with family history, highlighting the fact that family history remains a strong, independent and easily assessed risk factor for type 2 diabetes. Discovering factors that will explain the association of family history with type 2 diabetes risk will provide important insight into the aetiology of type 2 diabetes.
