title: Familial aggregation of diabetes and hypertension in a case-control study of colorectal neoplasia.
abstract: Familial aggregation of diseases potentially associated with metabolic syndrome (diabetes mellitus, hypertension, and cardiovascular diseases) was assessed in a colonoscopy-based case-control study of colorectal neoplasia in Toronto and Ottawa, Canada, in 1993-1996. Each familial disease was analyzed by logistic regression using generalized estimating equations. Case probands had incident adenomatous polyps (n = 172) or incident (n = 25) or prevalent (n = 132) colorectal cancer (CRC), while control probands (n = 282) had a negative colonoscopy and no history of CRC or polyps. Significant effect modification was evident in the data, with the strongest positive associations between familial diabetes and colorectal neoplasia among older probands with symptoms (parents: odds ratio (OR) = 2.4, 95% confidence interval (CI): 1.2, 4.8; siblings: OR = 5.8, 95% CI: 2.6, 13.3). Familial hypertension was also associated with colorectal neoplasia among probands with symptoms (OR = 1.7, 95% CI: 1.1, 2.6). In stratified analyses, familial diabetes, hypertension, and stroke were positively associated with adenomatous polyps in subgroups of probands who were older and/or had symptoms, while only familial diabetes was possibly associated with CRC. Associations in other proband groups may have been obscured by high cumulative incidence of parental CRC. Family studies are needed to understand the contribution of specific environmental and genetic factors in accounting for the disease aggregations.
authors.affiliation: Department of Public Health Sciences, University of Toronto, Ontario, Canada. pbrauer@uoguelph.ca
authors.forename: Paula M
authors.initials: PM
authors.lastname: Brauer
authors.forename: Gail E
authors.initials: GE
authors.lastname: McKeown-Eyssen
authors.forename: Vartouhi
authors.initials: V
authors.lastname: Jazmaji
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Logan
authors.forename: David F
authors.initials: DF
authors.lastname: Andrews
authors.forename: David
authors.initials: D
authors.lastname: Jenkins
authors.forename: Norman
authors.initials: N
authors.lastname: Marcon
authors.forename: Fred
authors.initials: F
authors.lastname: Saibil
authors.forename: Lawrence
authors.initials: L
authors.lastname: Cohen
authors.forename: Hartley
authors.initials: H
authors.lastname: Stern
authors.forename: David
authors.initials: D
authors.lastname: Baron
authors.forename: Gordon
authors.initials: G
authors.lastname: Greenberg
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Diamandis
authors.forename: Gary
authors.initials: G
authors.lastname: Kakis
authors.forename: William
authors.initials: W
authors.lastname: Singer
authors.forename: George
authors.initials: G
authors.lastname: Steiner
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000235:genetics*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology / Q000235:genetics*; D015994:Incidence; D007333:Insulin Resistance; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010375:Pedigree; D012044:Regression Analysis