Racial differences in the interaction between family  history and risk factors associated with diabetes in the  National Health and Nutritional Examination Survey,  1999-2004.
OBJECTIVE
We sought to determine whether the association between family history, a surrogate for genetic predisposition, and diabetes was modified by any known diabetes risk factors and if these relationships were constant across different ethnic groups.


METHODS
We examined 10,899 adults from the National Health and Nutrition Examination Survey (1999 -2004) to identify interactions between family history and clinical, demographic, and lifestyle variables for the outcome of diabetes using logistic regression analysis in racial/ethnic subgroups.


RESULTS
There was significant heterogeneity by race/ethnicity in the interaction between covariates and family history in relation to diabetes. In black (P = 0.0001) and Hispanic (P = 0.013), but not white (P = 0.75) subgroups, high-familial risk was a strong risk factor for diabetes among lean individuals but less so among overweight or obese subjects.Among blacks, high-familial risk conferred a 20-fold increased odds of diabetes among lean subjects and only a sixfold increased odds among obese individuals.


CONCLUSIONS
These findings suggest possible race/ethnic-specific differences in gene by environment interaction and identify body mass index as an important effect modifier of familial risk in diabetes in non-white populations. These findings may help guide future genetic studies and improve the utility of family history as a public health screening tool.
Suchindran
Sunil
S
Center for Genomic Medicine, Institute for Genome Sciences and Policy, Duke University Medical Center, Durham, North Carolina 27710, USA.
Vana
Alicia M
AM
Shaffer
Richard A
RA
Alcaraz
John E
JE
McCarthy
Jeanette J
JJ
D000328:Adult; D001741:Black or African American / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data*; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology* / Q000235:genetics; D005192:Family Health; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data*; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014481:United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data*
D008076:Cholesterol, HDL; D014280:Triglycerides