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1Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
2Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea
3Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
4Cancer Research Institute, Seoul National University, Seoul, Korea
5Department of Biomedicine Sciences, Seoul National University Graduate School, Seoul, Korea
© 2023, Korean Society of Epidemiology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
The authors have no conflicts of interest to declare for this study.
FUNDING
None.
AUTHOR CONTRIBUTIONS
Conceptualization: Lee JY, Park SK. Data curation: Kim K, Lee S, An WJ. Formal analysis: Lee JY, Kim K. Funding acquisition: None. Methodology: Lee JY, Park SK. Project administration: Park SK. Visualization: Lee JY. Writing – original draft: Lee JY. Writing – review & editing: Lee JY, Kim K, Lee S, An WJ, Park SK.
DM status of relatives | No DM | Late-onset DM | Common-onset DM | Early-onset DM | p-value1 | DM in 1 relative | DM in ≥2 relatives | p-value1 |
---|---|---|---|---|---|---|---|---|
Total participants (n) | 176,685 | 13,203 | 12,025 | 1,390 | 30,206 | 4,682 | ||
Male | 64,124 (36.3) | 4,223 (32.0) | 3,672 (30.5) | 449 (32.3) | <0.001 | 9,401 (31.1) | 1,315 (28.1) | <0.001 |
Low income (≤3 decile) | 56,591 (40.1) | 3,292 (28.6) | 3,044 (28.3) | 396 (33.5) | <0.001 | 7,674 (30.3) | 1,211 (30.7) | <0.001 |
Current smokers | 74,795 (42.3) | 697 (5.3) | 545 (4.5) | 110 (7.9) | <0.001 | 1,832 (6.1) | 227 (4.9) | <0.001 |
Current drinkers | 78,243 (44.3) | 6,100 (46.2) | 5,586 (46.5) | 667 (48.0) | <0.001 | 13,896 (46.0) | 1,980 (42.3) | <0.001 |
Low physical activity | 89,337 (50.5) | 6,026 (45.6) | 5,323 (44.3) | 682 (49.1) | <0.001 | 14,113 (46.7) | 2,118 (45.2) | <0.001 |
Age (yr) | 54±9 | 52±8 | 51±8 | 50±7 | <0.001 | 52±8 | 53±8 | <0.001 |
Body mass index (kg/m2) | 23.9±2.9 | 23.9±2.9 | 24.1±3.0 | 24.1±3.0 | <0.001 | 24.0±2.9 | 24.2±3.0 | <0.001 |
Systolic blood pressure (mmHg) | 123.3±16.2 | 121.4±15.2 | 121.9±15.2 | 121.1±15.8 | <0.001 | 121.9±15.4 | 122.3±15.1 | <0.001 |
Diastolic blood pressure (mmHg) | 77.0±10.4 | 75.7±10.0 | 75.8±10.0 | 76.2±10.5 | <0.001 | 76.1±10.1 | 75.9±9.8 | <0.001 |
Serum total cholesterol (mg/dL) | 232±1,854 | 205±869 | 213±1,287 | 269±2,677 | 0.206 | 211±1,148 | 240±2,060 | 0.141 |
Energy intake per day (kcal) | 1,753±599 | 1,773±594 | 1,764±600 | 1,795±611 | <0.001 | 1,771±595 | 1,725±578 | <0.001 |
Fasting plasma glucose (mg/dL) | 95±20 | 98±25 | 100±29 | 102±31 | <0.001 | 100±27 | 106±33 | <0.001 |
HbA1c (%) | 5.7±0.7 | 5.8±0.9 | 5.9±1.0 | 6.1±1.3 | <0.001 | 5.8±0.9 | 6.2±1.2 | <0.001 |
Group | Incident DM cases (n) | Non-DM cases (n) | HR (95% CI)1 | HR (95% CI)2 | |
---|---|---|---|---|---|
No parental diabetes | 4,527 | 68,712 | 1.00 (reference) | 1.00 (reference) | |
At least 1 parent with diabetes | |||||
Unilateral parental diabetes | 884 | 7,841 | 2.20 (2.04, 2.37) | 2.03 (1.87, 2.21) | |
Bilateral parental diabetes | 57 | 388 | 3.25 (2.50, 4.23) | 2.69 (2.00, 3.61) | |
No parental diabetes | 4,527 | 68,712 | 1.00 (reference) | 1.00 (reference) | |
At least 1 parent with diabetes | |||||
Late onset | 429 | 4,379 | 1.99 (1.81, 2.21) | 1.87 (0.99, 3.40) | |
Common onset | 260 | 2,206 | 2.90 (2.60, 3.29) | 2.50 (2.19, 2.87) | |
Early onset | 14 | 152 | 2.31 (1.37, 3.91) | 1.83 (0.98, 3.40) | |
No sibling diabetes | 4,860 | 72,901 | 1.00 (reference) | 1.00 (reference) | |
At least 1 sibling with diabetes | |||||
1 sibling | 514 | 3,628 | 2.05 (1.87, 2.24) | 1.90 (1.71, 2.11) | |
≥2 siblings | 94 | 412 | 3.71 (3.02, 4.54) | 2.74 (2.17, 3.47) | |
No sibling diabetes | 4,860 | 72,901 | 1.00 (reference) | 1.00 (reference) | |
At least 1 sibling with diabetes | |||||
Late onset | 95 | 683 | 1.91 (1.56, 2.34) | 1.68 (1.34, 2.12) | |
Common onset | 288 | 2,057 | 2.37 (2.11, 2.67) | 2.09 (1.83, 2.38) | |
Early onset | 49 | 338 | 2.44 (1.84, 3.23) | 2.61 (1.87, 3.64) | |
No. of diabetes in first- to second-degree relatives | |||||
0 | 4,057 | 65,447 | 1.00 (reference) | 1.00 (reference) | |
1 | 1152 | 10,075 | 2.18 (2.04, 2.32) | 2.02 (1.88, 2.18) | |
≥2 | 259 | 1,419 | 3.45 (3.04, 3.91) | 2.88 (2.50, 3.33) | |
No relative with diabetes | 4,057 | 65,447 | 1.00 (reference) | 1.00 (reference) | |
Diabetes onset in first- to second-degree relatives | |||||
Late onset | 470 | 4,702 | 2.03 (1.84, 2.23) | 1.87 (1.68, 2.08) | |
Common onset | 519 | 4,058 | 2.69 (2.45, 3.06) | 2.45 (2.21, 2.71) | |
Early onset | 62 | 479 | 2.88 (2.09, 3.45) | 2.72 (2.03, 3.66) |
DM, diabetes mellitus; HR, hazard ratio; CI, confidence interval.
1 Adjusted for age and sex.
2 Adjusted for age, sex, cigarette smoking, alcohol consumption, physical activity, total energy intake, body mass index, waist-hip ratio, systolic blood pressure, and blood levels of total cholesterol, high-density lipoprotein cholesterol, triglyceride, alanine aminotransferase, pulse rate, γ-glutamyl transpeptidase, and fasting glucose.
Status of family history for DM |
HTN cases, n (%) | OR (95% CI)1 | CKD cases, n (%) | OR (95% CI)2 | CVD cases, n (%) | OR (95% CI)2 | ||
---|---|---|---|---|---|---|---|---|
Parental DM | Sibling DM | Participant DM | ||||||
- | - | - | 36,252 (21.3) | 1.00 (reference) | 6,569 (3.9) | 1.00 (reference) | 7,719 (4.5) | 1.00 (reference) |
- | - | + | 7,333 (43.5) | 1.95 (1.87, 2.02) | 1,723 (10.3) | 2.09 (1.94, 2.25) | 1,647 (9.8) | 1.55 (1.45, 1.65) |
+ | - | + | 1,423 (37.5) | 2.06 (1.91, 2.22) | 247 (6.5) | 2.64 (2.26, 3.08) | 274 (7.2) | 1.62 (1.40, 1.85) |
- | - | - | 37,079 (20.5) | 1.00 (reference) | 6,467 (3.6) | 1.00 (reference) | 7,734 (4.3) | 1.00 (reference) |
- | - | + | 7,589 (42.5) | 2.01 (1.93, 2.09) | 1,661 (9.3) | 2.09 (1.94, 2.25) | 1,654 (9.3) | 1.56 (1.46, 1.66) |
- | + | + | 1,167 (41.8) | 1.81 (1.66, 1.98) | 309 (11.1) | 2.82 (2.42, 3.28) | 267 (9.6) | 1.71 (1.48, 1.98) |
- | - | - | 34,127 (21.1) | 1.00 (reference) | 6,185 (3.8) | 1.00 (reference) | 7,247 (4.5) | 1.00 (reference) |
- | - | + | 6,403 (43.5) | 1.98 (1.89, 2.06) | 1,459 (9.9) | 2.00 (1.85, 2.16) | 1,440 (9.8) | 1.55 (1.45, 1.67) |
+ | + | + | 2,353 (40.7) | 2.00 (1.87, 2.12) | 511 (8.6) | 2.74 (2.44, 3.09) | 481 (8.1) | 1.63 (1.47, 1.82) |
- | - | - | 34,127 (21.1) | 1.00 (reference) | 6,185 (3.8) | 1.00 (reference) | 7,247 (4.5) | 1.00 (reference) |
+/ Late | +/ Late | + | 759 (34.3) | 1.91 (1.71, 2.12) | 160 (8.3) | 2.61 (2.14, 3.18) | 157 (8.1) | 1.54 (1.28, 1.86) |
+/ Common | +/ Common | + | 850 (38.2) | 1.91 (1.74, 2.11) | 153 (6.9) | 2.60 (2.15, 3.15) | 171 (7.7) | 1.69 (1.43, 2.00) |
+/ Early | +/ Early | + | 99 (39.3) | 1.87 (1.37, 2.55) | 23 (8.0) | 4.31 (2.55, 7.27) | 13 (4.5) | 1.03 (0.52, 2.03) |
- | - | - | 34,127 (21.1) | 1.00 (reference) | 6,185 (3.8) | 1.00 (reference) | 7,247 (4.5) | 1.00 (reference) |
- | + | - | 2,125 (26.6) | 1.13 (1.07, 1.20) | 384 (4.8) | 1.14 (0.99, 1.32) | 472 (4.5) | 1.20 (1.07, 1.35) |
+ | - | - | 2,952 (15.4) | 1.00 (0.96, 1.05) | 282 (1.5) | 0.95 (0.82, 1.10) | 487 (2.6) | 0.99 (0.89, 1.09) |
+ | + | - | 339 (18.3) | 0.99 (0.85, 1.12) | 39 (2.1) | 1.00 (0.67, 1.47) | 74 (4.0) | 1.09 (0.82, 1.44) |
DM, diabetes mellitus; HTN, hypertension; CKD, chronic kidney disease; CVD, cardiovascular disease; OR, odds ratio; CI, confidence interval.
1 Adjusted for age, sex, cigarette smoking, alcohol consumption, physical activity, body mass index, and blood levels of total cholesterol, total energy intake, and fasting glucose.
2 Adjusted for age, sex, cigarette smoking, alcohol consumption, physical activity, body mass index, systolic blood pressure, and blood levels of total cholesterol, total energy intake, and fasting glucose.
DM status of relatives | No DM | Late-onset DM | Common-onset DM | Early-onset DM | p-value |
DM in 1 relative | DM in ≥2 relatives | p-value |
---|---|---|---|---|---|---|---|---|
Total participants (n) | 176,685 | 13,203 | 12,025 | 1,390 | 30,206 | 4,682 | ||
Male | 64,124 (36.3) | 4,223 (32.0) | 3,672 (30.5) | 449 (32.3) | <0.001 | 9,401 (31.1) | 1,315 (28.1) | <0.001 |
Low income (≤3 decile) | 56,591 (40.1) | 3,292 (28.6) | 3,044 (28.3) | 396 (33.5) | <0.001 | 7,674 (30.3) | 1,211 (30.7) | <0.001 |
Current smokers | 74,795 (42.3) | 697 (5.3) | 545 (4.5) | 110 (7.9) | <0.001 | 1,832 (6.1) | 227 (4.9) | <0.001 |
Current drinkers | 78,243 (44.3) | 6,100 (46.2) | 5,586 (46.5) | 667 (48.0) | <0.001 | 13,896 (46.0) | 1,980 (42.3) | <0.001 |
Low physical activity | 89,337 (50.5) | 6,026 (45.6) | 5,323 (44.3) | 682 (49.1) | <0.001 | 14,113 (46.7) | 2,118 (45.2) | <0.001 |
Age (yr) | 54±9 | 52±8 | 51±8 | 50±7 | <0.001 | 52±8 | 53±8 | <0.001 |
Body mass index (kg/m2) | 23.9±2.9 | 23.9±2.9 | 24.1±3.0 | 24.1±3.0 | <0.001 | 24.0±2.9 | 24.2±3.0 | <0.001 |
Systolic blood pressure (mmHg) | 123.3±16.2 | 121.4±15.2 | 121.9±15.2 | 121.1±15.8 | <0.001 | 121.9±15.4 | 122.3±15.1 | <0.001 |
Diastolic blood pressure (mmHg) | 77.0±10.4 | 75.7±10.0 | 75.8±10.0 | 76.2±10.5 | <0.001 | 76.1±10.1 | 75.9±9.8 | <0.001 |
Serum total cholesterol (mg/dL) | 232±1,854 | 205±869 | 213±1,287 | 269±2,677 | 0.206 | 211±1,148 | 240±2,060 | 0.141 |
Energy intake per day (kcal) | 1,753±599 | 1,773±594 | 1,764±600 | 1,795±611 | <0.001 | 1,771±595 | 1,725±578 | <0.001 |
Fasting plasma glucose (mg/dL) | 95±20 | 98±25 | 100±29 | 102±31 | <0.001 | 100±27 | 106±33 | <0.001 |
HbA1c (%) | 5.7±0.7 | 5.8±0.9 | 5.9±1.0 | 6.1±1.3 | <0.001 | 5.8±0.9 | 6.2±1.2 | <0.001 |
Group | Incident DM cases (n) | Non-DM cases (n) | HR (95% CI) |
HR (95% CI) |
|
---|---|---|---|---|---|
No parental diabetes | 4,527 | 68,712 | 1.00 (reference) | 1.00 (reference) | |
At least 1 parent with diabetes | |||||
Unilateral parental diabetes | 884 | 7,841 | 2.20 (2.04, 2.37) | 2.03 (1.87, 2.21) | |
Bilateral parental diabetes | 57 | 388 | 3.25 (2.50, 4.23) | 2.69 (2.00, 3.61) | |
No parental diabetes | 4,527 | 68,712 | 1.00 (reference) | 1.00 (reference) | |
At least 1 parent with diabetes | |||||
Late onset | 429 | 4,379 | 1.99 (1.81, 2.21) | 1.87 (0.99, 3.40) | |
Common onset | 260 | 2,206 | 2.90 (2.60, 3.29) | 2.50 (2.19, 2.87) | |
Early onset | 14 | 152 | 2.31 (1.37, 3.91) | 1.83 (0.98, 3.40) | |
No sibling diabetes | 4,860 | 72,901 | 1.00 (reference) | 1.00 (reference) | |
At least 1 sibling with diabetes | |||||
1 sibling | 514 | 3,628 | 2.05 (1.87, 2.24) | 1.90 (1.71, 2.11) | |
≥2 siblings | 94 | 412 | 3.71 (3.02, 4.54) | 2.74 (2.17, 3.47) | |
No sibling diabetes | 4,860 | 72,901 | 1.00 (reference) | 1.00 (reference) | |
At least 1 sibling with diabetes | |||||
Late onset | 95 | 683 | 1.91 (1.56, 2.34) | 1.68 (1.34, 2.12) | |
Common onset | 288 | 2,057 | 2.37 (2.11, 2.67) | 2.09 (1.83, 2.38) | |
Early onset | 49 | 338 | 2.44 (1.84, 3.23) | 2.61 (1.87, 3.64) | |
No. of diabetes in first- to second-degree relatives | |||||
0 | 4,057 | 65,447 | 1.00 (reference) | 1.00 (reference) | |
1 | 1152 | 10,075 | 2.18 (2.04, 2.32) | 2.02 (1.88, 2.18) | |
≥2 | 259 | 1,419 | 3.45 (3.04, 3.91) | 2.88 (2.50, 3.33) | |
No relative with diabetes | 4,057 | 65,447 | 1.00 (reference) | 1.00 (reference) | |
Diabetes onset in first- to second-degree relatives | |||||
Late onset | 470 | 4,702 | 2.03 (1.84, 2.23) | 1.87 (1.68, 2.08) | |
Common onset | 519 | 4,058 | 2.69 (2.45, 3.06) | 2.45 (2.21, 2.71) | |
Early onset | 62 | 479 | 2.88 (2.09, 3.45) | 2.72 (2.03, 3.66) |
Status of family history for DM |
HTN cases, n (%) | OR (95% CI) |
CKD cases, n (%) | OR (95% CI) |
CVD cases, n (%) | OR (95% CI) |
||
---|---|---|---|---|---|---|---|---|
Parental DM | Sibling DM | Participant DM | ||||||
- | - | - | 36,252 (21.3) | 1.00 (reference) | 6,569 (3.9) | 1.00 (reference) | 7,719 (4.5) | 1.00 (reference) |
- | - | + | 7,333 (43.5) | 1.95 (1.87, 2.02) | 1,723 (10.3) | 2.09 (1.94, 2.25) | 1,647 (9.8) | 1.55 (1.45, 1.65) |
+ | - | + | 1,423 (37.5) | 2.06 (1.91, 2.22) | 247 (6.5) | 2.64 (2.26, 3.08) | 274 (7.2) | 1.62 (1.40, 1.85) |
- | - | - | 37,079 (20.5) | 1.00 (reference) | 6,467 (3.6) | 1.00 (reference) | 7,734 (4.3) | 1.00 (reference) |
- | - | + | 7,589 (42.5) | 2.01 (1.93, 2.09) | 1,661 (9.3) | 2.09 (1.94, 2.25) | 1,654 (9.3) | 1.56 (1.46, 1.66) |
- | + | + | 1,167 (41.8) | 1.81 (1.66, 1.98) | 309 (11.1) | 2.82 (2.42, 3.28) | 267 (9.6) | 1.71 (1.48, 1.98) |
- | - | - | 34,127 (21.1) | 1.00 (reference) | 6,185 (3.8) | 1.00 (reference) | 7,247 (4.5) | 1.00 (reference) |
- | - | + | 6,403 (43.5) | 1.98 (1.89, 2.06) | 1,459 (9.9) | 2.00 (1.85, 2.16) | 1,440 (9.8) | 1.55 (1.45, 1.67) |
+ | + | + | 2,353 (40.7) | 2.00 (1.87, 2.12) | 511 (8.6) | 2.74 (2.44, 3.09) | 481 (8.1) | 1.63 (1.47, 1.82) |
- | - | - | 34,127 (21.1) | 1.00 (reference) | 6,185 (3.8) | 1.00 (reference) | 7,247 (4.5) | 1.00 (reference) |
+/ Late | +/ Late | + | 759 (34.3) | 1.91 (1.71, 2.12) | 160 (8.3) | 2.61 (2.14, 3.18) | 157 (8.1) | 1.54 (1.28, 1.86) |
+/ Common | +/ Common | + | 850 (38.2) | 1.91 (1.74, 2.11) | 153 (6.9) | 2.60 (2.15, 3.15) | 171 (7.7) | 1.69 (1.43, 2.00) |
+/ Early | +/ Early | + | 99 (39.3) | 1.87 (1.37, 2.55) | 23 (8.0) | 4.31 (2.55, 7.27) | 13 (4.5) | 1.03 (0.52, 2.03) |
- | - | - | 34,127 (21.1) | 1.00 (reference) | 6,185 (3.8) | 1.00 (reference) | 7,247 (4.5) | 1.00 (reference) |
- | + | - | 2,125 (26.6) | 1.13 (1.07, 1.20) | 384 (4.8) | 1.14 (0.99, 1.32) | 472 (4.5) | 1.20 (1.07, 1.35) |
+ | - | - | 2,952 (15.4) | 1.00 (0.96, 1.05) | 282 (1.5) | 0.95 (0.82, 1.10) | 487 (2.6) | 0.99 (0.89, 1.09) |
+ | + | - | 339 (18.3) | 0.99 (0.85, 1.12) | 39 (2.1) | 1.00 (0.67, 1.47) | 74 (4.0) | 1.09 (0.82, 1.44) |
Values are presented as number (%) or mean±standard deviation. DM, diabetes; HbA1c, hemoglobin A1c. p-values for differences among the 3 groups: tested with analysis of variance for continuous scales or chi-square test for categorical scales.
DM, diabetes mellitus; HR, hazard ratio; CI, confidence interval. Adjusted for age and sex. Adjusted for age, sex, cigarette smoking, alcohol consumption, physical activity, total energy intake, body mass index, waist-hip ratio, systolic blood pressure, and blood levels of total cholesterol, high-density lipoprotein cholesterol, triglyceride, alanine aminotransferase, pulse rate, γ-glutamyl transpeptidase, and fasting glucose.
DM, diabetes mellitus; HTN, hypertension; CKD, chronic kidney disease; CVD, cardiovascular disease; OR, odds ratio; CI, confidence interval. Adjusted for age, sex, cigarette smoking, alcohol consumption, physical activity, body mass index, and blood levels of total cholesterol, total energy intake, and fasting glucose. Adjusted for age, sex, cigarette smoking, alcohol consumption, physical activity, body mass index, systolic blood pressure, and blood levels of total cholesterol, total energy intake, and fasting glucose.