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Childhood psychosocial health predicts type 2 diabetes risk in adulthood
Finnish children who scored higher in psychosocial health measures were less likely to develop type 2 diabetes as adults compared with children who had lower scores, according to findings from a long-term, prospective study.
“The early years of life are extremely important for our future health,” Laura Pulkki-Råback, PhD, an adjunct professor at the University of Helsinki, told Endocrine Today. “A stable and supportive early environment gives good resilience against the development of obesity and diabetes. Our interpretation is that this is because children growing up under positive family circumstances have better role models for healthy lifestyles and more support in adhering to them.”
Pulkki-Råback and colleagues analyzed data from 3,553 Finnish children without type 1 diabetes randomly chosen from the population register as part of the Cardiovascular Risk in Young Finns Study. The cohort was followed into adulthood from 1980 to 2012; 2,044 remained through follow-up. Parents completed a baseline questionnaire and a total positive psychosocial score was based on six subdomains, including socioeconomic status, favorable emotional environment, parental health behaviors, absence of stressful events, self-control of the child and social adjustment of the child. Glucose levels were measured at baseline and again in 1986, 2001, 2007 and 2012. Researchers used RR ratios to examine the association between total positive childhood psychosocial score and each of its subdomains with prediabetes and type 2 diabetes in adulthood.
In 2012, 3.4% had type 2 diabetes; 33.4% had prediabetes; mean glucose levels for the cohort increased from 4.63 mmol/L to 5.44 mmol/L.
Researchers observed a 21% decrease in the rate of type 2 diabetes for each 1-standard deviation (SD) increase in positive psychosocial score after adjusting for childhood CV risk factors and dietary behaviors (RR = 0.79; 95% CI, 0.66-0.94), as well as an 8% decrease in the rate of prediabetes (RR = 0.95; 95% CI, 0.86-0.98). Adult BMI mediated 52% of the association, whereas weight gain mediated 25%, according to the researchers; age and sex did not modify results.
When assessing risk by subdomains, researchers found that each 1-SD increase in healthy parental behaviors was associated with a 23% reduced risk for developing type 2 diabetes (P = .003), and each 1-SD increase in absence of stressful events was associated with a 14% reduced risk for type 2 diabetes (P = .04). In linear regression analyses, higher psychosocial score was associated with lower glucose levels at each follow-up; the growth curve model showed healthier glucose trajectories for participants with higher vs. lower positive psychosocial score in childhood.
“It is important that the practitioner asks about the life circumstances of the patient,” Pulkki-Råback said. “For instance, if the patient has a stressful life situation, it is not wise to recommend major lifestyle changes as the stressful situation is ongoing. When meeting families with children, it is important to recognize that parents’ behaviors have an enormous effect on child behavior. So, promoting the health of children begins with interventions directed at the parents. The younger the child, the more parents have an effect.” – by Regina Schaffer
For more information:
Laura Pulkki-Råback, PhD, can be reached at the Helsinki Collegium for Advanced Studies, P.O. Box 4, 00014, University of Helsinki, Helsinki, Finland; email: laura.pulkki-raback@helsinki.fi.
Disclosure: The researchers report no relevant financial disclosures.