Effect of family history of diabetes and obesity status on lifetime risk of type 2 diabetes in the Iranian population

Abstract

Background: Data are scarce for the lifetime risk of diabetes in the Middle East and North Africa region countries. We estimated the lifetime risk of type 2 diabetes among Iranian adults at age 20 and 40 years, and their variation by family history of diabetes and body mass index (BMI).

Methods: The data from 8435 diabetes-free participants from the Tehran Lipid and Glucose study were used in this analysis. We estimated the lifetime risk of diabetes stratified by sex, and quantified the impact of family history of diabetes and BMI status on the lifetime risks, singly and jointly.

Results: At age 20 years, the overall lifetime risk of diabetes was 57.8% (95% CI = 54.0%-61.8%) for men and 61.3% (57.2%-65.4%) for women. Having both family history of diabetes and increased level of BMI, alone, increased the lifetime risk of diabetes in both sexes. Moreover, the simultaneous presence of family history of diabetes and overweigh/obesity increased the lifetime risk of diabetes in both sexes. So that, at age 20 years the lifetime risk in obese men with positive family history of diabetes was about 54% higher, compared to normal weight men without family history of diabetes; the corresponding value for women was 42%. Also, normal weight men without family history of diabetes lived 24 years longer free of diabetes, compared with obese men with family history of diabetes. In women, the corresponding value was 20 years.

Conclusion: Our study shows the alarming lifetime risk of diabetes across the strata of BMI, which emphasizes the need for more effective interventions to reduce incidence, particularly, among individuals with positive family history of diabetes.

Figure 1

Flowchart of sample selection for the study.

Figure 2

Lifetime risk of diabetes adjusted for the competing risk of death: Panel A. At age 20 years. Panel B. At age 40 years.

Figure 3

Lifetime risk of diabetes, adjusted for the competing risk of death, by categories of body mass index (BMI) and family history of diabetes: Panel A. At age 20 years. Panel B. At age 40 years.

Figure 4

Survival free of diabetes (years) by body mass index and family history of diabetes: Panel A. After the age of 20. Panel B. After the age of 40 years.

Figure 5

Survival free of diabetes (years) after the age of 20 years by body mass index and family history of diabetes: Panel A. Among men. Panel B. Among women.