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An Early-Onset Subgroup of Type 2 Diabetes: A Multigenerational, Prospective Analysis in the Framingham Heart Study




TekijätEchouffo-Tcheugui Justin B, Niiranen Teemu J, McCabe Elizabeth L, Henglin Mir, Jain Mohit, Vasan Ramachandran S, Larson Martin G, Cheng Susan

KustantajaAMER DIABETES ASSOC

Julkaisuvuosi2020

JournalDiabetes Care

Tietokannassa oleva lehden nimiDIABETES CARE

Lehden akronyymiDIABETES CARE

Vuosikerta43

Numero12

Aloitussivu3086

Lopetussivu3093

Sivujen määrä8

ISSN0149-5992

eISSN1935-5548

DOIhttps://doi.org/10.2337/dc19-1758

Verkko-osoitehttps://diabetesjournals.org/care/article/43/12/3086/31094/An-Early-Onset-Subgroup-of-Type-2-Diabetes-A


Tiivistelmä
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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