The role of adiposity and lifestyle in the relationship between family history of diabetes and 20-year incidence of type 2 diabetes in U.S. women
- Esther van 't Riet, MSc (e.vantriet{at}vumc.nl)1,2,3,
- Jacqueline M. Dekker, PhD2,3,
- Qi Sun, PhD1,
- Giel Nijpels, MD, PhD2,4,
- Frank B. Hu, MD, PhD1,5,6 and
- Rob. M. van Dam, PhD (rvandam{at}hsph.harvard.edu)1,5,6
- 1 Dept. of Nutrition, Harvard School of Public Health, Boston, MA 02115, United States
- 2 EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- 3 Dept. of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
- 4 Dept. of General Practice, VU University Medical Center, Amsterdam, The Netherlands
- 5 Dept. of Epidemiology, Harvard School of Public Health, Boston, MA 02115, United States
- 6 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States
Abstract
Objective: To evaluate to what extent the association between family history of diabetes and risk of type 2 diabetes can be explained by excess adiposity and lifestyle risk factors.
Research design and methods: We analyzed data from 73,227 women who participated in the Nurses' Health Study cohort. A family history of diabetes was defined as having at least one first degree family member with diabetes. Lifestyle factors, weight and height were assessed by using validated questionnaires, and body mass index (BMI) was calculated. The relative risk of type 2 diabetes was estimated using Cox proportional hazards analysis.
Results: We documented 5101 cases of type 2 diabetes during 20 years of follow-up. The age-adjusted relative risk of type 2 diabetes in participants with a family history was 2.27 (95% CI 2.14-2.40) as compared with those without a family history of diabetes. Participants with a family history of diabetes had a higher BMI and were more likely to have a parental history of obesity. BMI explained 21.1% (95% CI 19.4-22.9) of the association between family history of diabetes and risk of type 2 diabetes. Intakes of red meat, alcohol and sugar-sweetened beverages explained 1.1% (95% CI 0.8-1.3), 4.8% (95% CI 4.3-5.3) and 2.8% (95% CI 2.4-3.2) of this association respectively.
Conclusions: These results suggest that excess adiposity and, to a lesser extent, specific dietary habits can explain a substantial part of the association between having a family history of diabetes and risk of type 2 diabetes.
Footnotes
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- Received August 25, 2009.
- Accepted December 27, 2009.
- Copyright © American Diabetes Association
