TY - JOUR
T1 - An early-onset subgroup of type 2 diabetes
T2 - A multigenerational, prospective analysis in the framingham heart study
AU - Echouffo-Tcheugui, Justin B.
AU - Niiranen, Teemu J.
AU - McCabe, Elizabeth L.
AU - Henglin, Mir
AU - Jain, Mohit
AU - Vasan, Ramachandran S.
AU - Larson, Martin G.
AU - Cheng, Susan
N1 - Funding Information:
Acknowledgments. The authors thank the staff and participants of the FHS. Funding. This work was supported by the National Heart, Lung, and Blood Institute’s FHS (contracts N01HC25195, HHSN268201500001I, and 75N92019D00031) and the following National Institutes of Health grants: T32 HL125232 (J.B.E.-T.), R01HL093328 (R.S.V.), R01HL107385 (R.S.V.), R01HL126136 (R.S.V.), R00HL107642 (S.C.), R01HL131532 (S.C.), and R01HL134168 (S.C.).
Funding Information:
The authors thank the staff and participants of the FHS. Funding. This work was supported by the National Heart, Lung, and Blood Institute?s FHS (contracts N01HC25195, HHSN268201500001I, and 75N92019D00031) and the following National Institutes of Health grants: T32 HL125232 (J.B.E.-T.), R01HL093328 (R.S.V.), R01HL107385 (R.S.V.), R01HL126136 (R.S.V.), R00HL107642 (S.C.), R01HL131532 (S.C.), and R01HL134168 (S.C.). The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services.
Publisher Copyright:
© 2020 by the American Diabetes Association.
PY - 2020/12
Y1 - 2020/12
N2 - OBJECTIVE To assess the relation of type 2 diabetes occurring earlier (age <55 years) versus later in life to the risk of cardiovascular death and to diabetes in offspring. RESEARCH DESIGN AND METHODS In the Framingham Heart Study, a community-based prospective cohort study, glycemic status was ascertained at serial examinations over six decades among 5,571 first-and second-generation participants with mortality data and 2,123 second-generation participants who initially did not have diabetes with data on parental diabetes status. We assessed cause of death in a case (cardiovascular death)–control (noncardiovascular death) design and incident diabetes in offspring in relation to parental early-onset diabetes. RESULTS Among the participants in two generations (N = 5,571), there were 1,822 cardiovascular deaths (including 961 coronary deaths). The odds of cardiovascular versus noncardiovascular death increased with decreasing age of diabetes onset (P < 0.001 trend). Compared with never developing diabetes, early-onset diabetes conferred a 1.81-fold odds (95% CI 1.10–2.97, P = 0.02) of cardiovascular death and 1.75-fold odds (0.96–3.21, P = 0.07) of coronary death, whereas later-onset diabetes was not associated with greater risk for either (P = 0.09 for cardiovascular death; P = 0.51 for coronary death). In second-generation participants, having a parent with early-onset diabetes increased diabetes risk by 3.24-fold (1.73–6.07), whereas having one or both parents with late-onset diabetes increased diabetes risk by 2.19-fold (1.50– 3.19). CONCLUSIONS Our findings provide evidence for a diabetes subgroup with an early onset, a stronger association with cardiovascular death, and higher transgenerational transmission.
AB - OBJECTIVE To assess the relation of type 2 diabetes occurring earlier (age <55 years) versus later in life to the risk of cardiovascular death and to diabetes in offspring. RESEARCH DESIGN AND METHODS In the Framingham Heart Study, a community-based prospective cohort study, glycemic status was ascertained at serial examinations over six decades among 5,571 first-and second-generation participants with mortality data and 2,123 second-generation participants who initially did not have diabetes with data on parental diabetes status. We assessed cause of death in a case (cardiovascular death)–control (noncardiovascular death) design and incident diabetes in offspring in relation to parental early-onset diabetes. RESULTS Among the participants in two generations (N = 5,571), there were 1,822 cardiovascular deaths (including 961 coronary deaths). The odds of cardiovascular versus noncardiovascular death increased with decreasing age of diabetes onset (P < 0.001 trend). Compared with never developing diabetes, early-onset diabetes conferred a 1.81-fold odds (95% CI 1.10–2.97, P = 0.02) of cardiovascular death and 1.75-fold odds (0.96–3.21, P = 0.07) of coronary death, whereas later-onset diabetes was not associated with greater risk for either (P = 0.09 for cardiovascular death; P = 0.51 for coronary death). In second-generation participants, having a parent with early-onset diabetes increased diabetes risk by 3.24-fold (1.73–6.07), whereas having one or both parents with late-onset diabetes increased diabetes risk by 2.19-fold (1.50– 3.19). CONCLUSIONS Our findings provide evidence for a diabetes subgroup with an early onset, a stronger association with cardiovascular death, and higher transgenerational transmission.
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U2 - 10.2337/dc19-1758
DO - 10.2337/dc19-1758
M3 - Article
C2 - 33033069
AN - SCOPUS:85096492665
SN - 0149-5992
VL - 43
SP - 3086
EP - 3093
JO - Diabetes care
JF - Diabetes care
IS - 12
ER -