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Family history of diabetes increases latent autoimmune diabetes risk
The risk for latent autoimmune diabetes in adults is increased in people with a family history of diabetes, and the risk was more pronounced among those with a family history of type 1 diabetes compared with type 2 diabetes, study data show.
Rebecka Hjort, MSc, a PhD student in the unit of epidemiology at the Institute of Environmental Medicine at Karolinska Institutet in Sweden, and colleagues evaluated data from the Epidemiological Study of Risk Factors for LADA and Type 2 Diabetes (ESTRID) on 378 adults with latent autoimmune diabetes, 1,199 adults with type 2 diabetes and 1,484 controls to determine the relationship between family history of diabetes and the risk for latent autoimmune diabetes in adults and type 2 diabetes.
A family history of type 1 diabetes was present in 10.1% of participants with latent autoimmune diabetes and 4.8% with type 2 diabetes and a family history of type 2 diabetes was present in 35.5% of participants with latent autoimmune diabetes and 46.2% with type 2 diabetes.
Participants with latent autoimmune diabetes were more likely to carry the DR4-DQ8 high-risk genotype and less likely to carry the DRX/X low-risk genotype compared with participants with type 2 diabetes. More participants who reported a family history of type 1 diabetes had the high-risk genotype (59%) compared with participants who reported a family history of type 2 diabetes (31.03%; P = .0006) and fewer had the low-risk genotype (12.8% vs. 44.4%; P < .0001).
The risk for latent autoimmune diabetes was twofold higher in participants who reported diabetes in first- or second-degree relatives and the risk continued to increase with the number and closeness of the relatives.
The risk for latent autoimmune diabetes was significantly greater with a family history of type 1 diabetes (OR = 5.8; 95% CI, 3.2-10.3) compared with a family history of type 2 diabetes (OR = 1.9; 95% CI, 1.5-2.5). The risk for type 2 diabetes was increased with a family history of type 2 diabetes (OR = 2.7; 95% CI, 2.2-3.3) but not a family history of type 1 diabetes.
Participants with latent autoimmune diabetes and a family history of type 1 diabetes had a lower prevalence of the low-risk genotype (5% vs. 28.6%) and a higher prevalence of the combined high-risk genotypes (90% vs. 69.1%) compared with participants with latent autoimmune diabetes and a family history of type 2 diabetes.
“Having both [type 1 diabetes] and [type 2 diabetes] in the family is associated with the risk of [latent autoimmune diabetes in adults], and the strong association with [family history of type 1 diabetes] suggests that genes related to autoimmunity are more influential in the development of [latent autoimmune diabetes in adults] than those related to [type 2 diabetes],” the researchers wrote. “Given this situation, it is noteworthy that, with regard to lifestyle, studies to date indicate that [latent autoimmune diabetes in adults] shares several risk factors with [type 2 diabetes], including smoking, alcohol consumption (protective) and low birth weight. Taken together, these findings indicate that [latent autoimmune diabetes in adults] development is promoted by genes related to autoimmunity and by lifestyle factors that increase insulin resistance.” – by Amber Cox
Disclosures: The authors reported no relevant financial disclosures.