Maternal Family History of Diabetes Is Associated With a Reduced Risk of Cardiovascular Disease in Women With Type 2 Diabetes

Abstract

OBJECTIVETo investigate whether parental family history of diabetes influences cardiovascular outcomes in type 2 diabetes.RESEARCH DESIGN AND METHODSWe studied 1,294 type 2 diabetic patients (mean age 64.1 years, 51.2% female) recruited to a community-based cohort study from 1993 to 1996 and followed until mid-2006. A data linkage system assessed all-cause and cardiac mortality, incident myocardial infarction, and stroke. Cox proportional hazards modeling was used to determine the influence of maternal or paternal family history on these outcomes.RESULTSA maternal family history of diabetes was reported by 20.4% of the cohort, 8.3% reported paternal family history, and 2.0% reported both parents affected. Maternal and paternal family history was associated with earlier age of diabetes onset, and maternal family history was associated with worse glycemic control. For all patients, maternal family history was significantly associated with reduced risk of all-cause mortality and cardiac mortality. When analyzed by sex, maternal family history had no effect on male patients, whereas female patients with diabetic mothers had significantly reduced hazard ratios for death from all causes (0.63 [95% CI 0.41–0.96]; P = 0.033), for death from cardiac causes (0.32 [0.14–0.72]; P = 0.006), and for first myocardial infarction (0.45 [0.26–0.76]; P = 0.003). Paternal family history status was not associated with these outcomes.CONCLUSIONSA maternal family history of diabetes confers relative protection against cardiovascular disease in female patients but not in male patients with type 2 diabetes. Paternal family history is associated with risks equivalent to those without a family history of diabetes. Some of the clinical heterogeneity of type 2 diabetes is related to maternal transmission effects with differential impact on male and female patients.

Transmission of Type 2 diabetes to sons and daughters: the D.E.S.I.R. cohort

“…Svensson et al [4] showed, in a crosssectional study of a Danish population, that more women than men had a parental transmission of diabetes, with a prevalence ratio of 1.19 (1.10, 1.30); however, this ratio was much lower than our observation of a two-to fourfold higher transmission to daughters than to sons. In the Fremantle Diabetes Study of people with diabetes, there was a marginally higher frequency of women having a family history of diabetes (33%) in comparison to men (29%) [3]. In Europe in general, diabetes is more frequent in men than in women.…”

“…Diabetes Study of people with diabetes, there was a marginally higher frequency of women having a family history of diabetes (33%) in comparison to men (29%) [3]. In Europe in general, diabetes is more frequent in men than in women.…”

“…In the InterAct study, the hazard ratios associated with a firstdegree family history of diabetes were 2.64 for men and 2.77 for women, essentially identical [2]. By contrast, in two cross-sectional studies of people with Type 2 diabetes, more women than men had a parental transmission of diabetes [3,4].…”

“…In the InterAct study, the hazard ratios associated with a firstdegree family history of diabetes were 2.64 for men and 2.77 for women, essentially identical [2]. By contrast, in two cross-sectional studies of people with Type 2 diabetes, more women than men had a parental transmission of diabetes [3,4].In the present study, we analyzed incident diabetes in men and women according to the presence of diabetes in first-and second-degree family members, and in particular in their father and their mother. The impact of a genetic risk score with 65 diabetes-related loci and maternal transmission of diabetes was also investigated.…”

Cardiovascular risk profiles in Type 2 diabetes and the impact of geographical setting

“…In terms of geographical distribution, a total of 14 articles were from Europe (including two from Germany [9,10], four from Italy [11][12][13][14], one from the Netherlands [15], four from Sweden [16][17][18][19] and three from the UK [20][21][22]), 20 were from the Asia-Pacific region (including three from Australia [23][24][25], 10 from China [26][27][28][29][30][31][32][33][34][35], five from Japan [36][37][38][39][40] and two from Taiwan [41,42]), 13 were from North America (including one from Canada [43] and 12 from the USA [44][45][46][47][48][49][50][51][52][53][54][55]), two were from the Middle East (both conducted in Iran …”