The impact of family history of diabetes and lifestyle factors on abnormal glucose regulation in middle-aged Swedish men and women.
OBJECTIVE
We investigated associations between abnormal glucose regulation and family history of diabetes, separately and in combination with lifestyle risk factors.


METHODS
This cross-sectional study comprised 3,128 men and 4,821 women, aged 35-56 years, half with a family history of diabetes. Oral glucose tolerance testing identified subjects with previously undiagnosed prediabetes (IFG, IGT) and type 2 diabetes. Information on lifestyle factors was obtained by questionnaire. Biological interaction was measured with the synergy index.


RESULTS
A family history of diabetes conferred a higher odds ratio (OR) for type 2 diabetes in men (OR=3.1, 95% CI 1.7-5.6) than in women (OR=1.7, 95% CI 1.0-3.0), and the synergy index was 2.8 (95% CI 0.9-9.0), suggesting interaction between a family history of diabetes and sex. For prediabetes and diabetes combined, the synergy index was 1.7 (1.0-2.8). Exposure to only one lifestyle risk factor (obesity, physical inactivity, smoking or low sense of coherence [a psychosocial index]) increased the risk to a similar extent in men and women. Combined exposure to a family history of diabetes and lifestyle-related risk factors had a greater effect on type 2 diabetes than any of these factors alone, especially in men. However, analysis of interaction between a family history of diabetes and the lifestyle factors did not indicate any interaction for diabetes, but did indicate interaction for a family history of diabetes and obesity in women with prediabetes.


CONCLUSIONS
Our data suggest a more pronounced effect of a family history of diabetes on the risk of type 2 diabetes in men than in women. While both a family history of diabetes and lifestyle risk factors had effects on type 2 diabetes, irrespective of sex, these effects did not appear to interact.
Hilding
A
A
Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institute, Stockholm, Sweden. agneta.hilding@ki.se
Eriksson
A-K
AK
Agardh
E E
EE
Grill
V
V
Ahlbom
A
A
Efendic
S
S
Ostenson
C-G
CG
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000235:genetics; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology* / Q000235:genetics; D005951:Glucose Tolerance Test; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013548:Sweden
D001786:Blood Glucose