Combined associations of family history and self-management with age at diagnosis and cardiometabolic risk in 86,931 patients with type 2 diabetes: Joint Asia Diabetes Evaluation (JADE) Register from 11 countries.

Autor: Cheung JTK; Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China., Lau E; Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region, Shatin, China.; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China., Tsui CCT; Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China., Siu ELN; Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China., Tse NKW; Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China., Hui NYL; Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China., Ma RCW; Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region, Shatin, China.; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China.; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China., Kong APS; Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region, Shatin, China.; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China.; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China., Fu A; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China., Lau V; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China., Jia W; Shanghai Sixth People's Hospital, Shanghai, China., Sheu WHH; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan., Sobrepena L; Heart of Jesus Hospital, San Jose City, Philippines., Yoon KH; Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea., Tan ATB; Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Chia YC; Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya, Selangor, Malaysia.; Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Sosale A; Diacon Hospital, Bangalore, India., Saboo BD; Dia Care - Diabetes Care & Hormone Clinic, Ahmedabad, Gujarat, India., Kesavadev J; Jothydev's Diabetes & Research Center, Thiruvananthapuram, Kerala, India., Goh SY; Department of Endocrinology, Singapore General Hospital, Singapore, Singapore., Nguyen TK; MEDIC Medical Centre, Ho Chi Minh City, Vietnam., Thewjitcharoen Y; Diabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand., Suwita R; Cerebrocardiovascular Diabetes Group Clinic (CDG), Jakarta, Indonesia., Luk AOY; Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region, Shatin, China.; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China.; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China., Yang A; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China.; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China., Chow E; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China.; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China., Lim LL; Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region, Shatin, China.; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China.; Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Chan JCN; Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region, Shatin, China. jchan@cuhk.edu.hk.; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China. jchan@cuhk.edu.hk.; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China. jchan@cuhk.edu.hk.; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China. jchan@cuhk.edu.hk.
Jazyk: angličtina
Zdroj: BMC medicine [BMC Med] 2022 Jul 14; Vol. 20 (1), pp. 249. Date of Electronic Publication: 2022 Jul 14.
DOI: 10.1186/s12916-022-02424-y
Abstrakt: Background: Family history (FamH) of type 2 diabetes might indicate shared genotypes, environments, and/or behaviors. We hypothesize that FamH interacts with unhealthy behaviors to increase the risk of early onset of diabetes and poor cardiometabolic control.
Methods: In a cross-sectional analysis of the prospective Joint Asia Diabetes Evaluation Register including patients from 427 clinics in 11 Asian countries/regions in 2007-2021, we defined positive FamH as affected parents/siblings and self-management as (1) healthy lifestyles (balanced diet, non-use of alcohol and tobacco, regular physical activity) and (2) regular self-monitoring of blood glucose (SMBG).
Results: Among 86,931 patients with type 2 diabetes (mean±SD age: 56.6±11.6 years; age at diagnosis of diabetes: 49.8±10.5 years), the prevalence of FamH ranged from 39.1% to 85.3% in different areas with FamH affecting mother being most common (32.5%). The FamH group (n=51,705; 59.5%) was diagnosed 4.6 years earlier than the non-FamH group [mean (95% CI): 47.9 (47.8-48.0) vs. 52.5 (52.4-52.6), logrank p<0.001]. In the FamH group, patients with both parents affected had the earliest age at diagnosis [44.6 (44.5-44.8)], followed by affected single parent [47.7 (47.6-47.8)] and affected siblings only [51.5 (51.3-51.7), logrank p<0.001]. The FamH plus ≥2 healthy lifestyle group had similar age at diagnosis [48.2 (48.1-48.3)] as the non-FamH plus <2 healthy lifestyle group [50.1 (49.8-50.5)]. The FamH group with affected parents had higher odds of hyperglycemia, hypertension, and dyslipidemia than the FamH group with affected siblings, with the lowest odds in the non-FamH group. Self-management (healthy lifestyles plus SMBG) was associated with higher odds of attaining HbA 1c <7%, blood pressure<130/80mmHg, and LDL-C<2.6 mmol/L especially in the FamH group (FamH×self-management, p interaction =0.050-0.001).
Conclusions: In Asia, FamH was common and associated with young age of diagnosis which might be delayed by healthy lifestyle while self management  was associated with better control of  cardiometabolic risk factors especially in those with FamH.
(© 2022. The Author(s).)
Databáze: MEDLINE
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