An Early-Onset Subgroup of Type 2 Diabetes: A Multigenerational, Prospective Analysis in the Framingham Heart Study

Abstract

OBJECTIVE To assess the relation of type 2 diabetes occurring earlier (age <55 years) versus later in life to the risk of cardiovascular death and to diabetes in offspring.

RESEARCH DESIGN AND METHODS In the Framingham Heart Study, a community-based prospective cohort study, glycemic status was ascertained at serial examinations over six decades among 5,571 first- and second-generation participants with mortality data and 2,123 second-generation participants who initially did not have diabetes with data on parental diabetes status. We assessed cause of death in a case (cardiovascular death)–control (noncardiovascular death) design and incident diabetes in offspring in relation to parental early-onset diabetes.

RESULTS Among the participants in two generations (N = 5,571), there were 1,822 cardiovascular deaths (including 961 coronary deaths). The odds of cardiovascular versus noncardiovascular death increased with decreasing age of diabetes onset (P < 0.001 trend). Compared with never developing diabetes, early-onset diabetes conferred a 1.81-fold odds (95% CI 1.10–2.97, P = 0.02) of cardiovascular death and 1.75-fold odds (0.96–3.21, P = 0.07) of coronary death, whereas later-onset diabetes was not associated with greater risk for either (P = 0.09 for cardiovascular death; P = 0.51 for coronary death). In second-generation participants, having a parent with early-onset diabetes increased diabetes risk by 3.24-fold (1.73–6.07), whereas having one or both parents with late-onset diabetes increased diabetes risk by 2.19-fold (1.50–3.19).

CONCLUSIONS Our findings provide evidence for a diabetes subgroup with an early onset, a stronger association with cardiovascular death, and higher transgenerational transmission.

Diabetes Care 2020 Dec; 43(12): 3086-3093. https://doi.org/10.2337/dc19-1758

Translation – The earlier you develop diabetes your risk of CVD and coronary death is higher. An if one or both of your parents developed either early onset or late onset diabetes you’re screwed.

Mothers’ Lifestyle Predicts When Offspring will have First Heart Attack or Stroke

Previous research has shown that parents pass on health to their offspring through both genes and shared environment/lifestyle. This was the first study to examine whether parents’ heart health was associated with the age at which offspring develop cardiovascular disease. In addition, it investigated the influence of each parent separately.

The study was conducted in offspring-mother-father trios from the Framingham Heart Study — a total of 1,989 offspring, 1,989 mothers, and 1,989 fathers. Offspring were enrolled at an average age of 32 years and followed over 46 years (1971-2017) for the development of cardiovascular events. “Crucially, the study followed offspring into most of their adult life when heart attacks and strokes actually occur,” explained Dr. Muchira

European Society of Cardiology. “Mothers’ lifestyle predicts when offspring will have first heart attack or stroke.” ScienceDaily, 4 November 2020. www.sciencedaily.com/releases/2020/11/201104194708.htm.

Journal Reference: Muchira JM, Gona PN, Mogos MF, et al. Parental cardiovascular health predicts time to onset of cardiovascular disease in offspring. Eur J Prev Cardiol., 2020 DOI: 10.1093/eurjpc/zwaa072

Eat More Broccoli

Published in the British Journal of Nutrition the research has found higher consumption of cruciferous vegetables, such as broccoli, Brussels sprouts and cabbage, is associated with less extensive blood vessel disease in older women.

Using data from a cohort of 684 older Western Australian women recruited in 1998, researchers from ECU’s School of Medical and Health Sciences and The University of Western Australia found those with a diet comprising more cruciferous vegetables had a lower chance of having extensive build-up of calcium on their aorta, a key marker for structural blood vessel disease.

Dr Blekkenhorst said women in this study who consumed more than 45g of cruciferous vegetables every day (e.g. ¼ cup of steamed broccoli or ½ cup of raw cabbage) were 46 percent less likely to have extensive build-up of calcium on their aorta in comparison to those consuming little to no cruciferous vegetables every day.

Edith Cowan University. “Broccoli and Brussels sprouts a cut above for blood vessel health.” ScienceDaily. http://www.sciencedaily.com/releases/2020/08/200820102434.htm (accessed August 20, 2020).

https://www.sciencedaily.com/releases/2020/08/200820102434.htm

Photo by Buenosia Carol on Pexels.com

Eat Nuts

Eating nuts linked with lower risk of fatal heart attack and stroke

Eating nuts two or more times per week was associated with a 17% lower risk of cardiovascular mortality compared to consuming nuts once every two weeks. The connection was robust even after adjusting for factors that could influence the relationship such as age, sex, education, smoking, and physical activity. Nut intake was inversely associated with the other outcomes but lost significance after adjustment.

Soy Protein Decreases Circulating LDL and Total Cholesterol Concentrations in Adults

Conclusions

Soy protein significantly reduced LDL cholesterol by approximately 3–4% in adults. Our data support the advice given to the general public internationally to increase plant protein intake. This trial was registered at clinicaltrials.gov as NCT03468127.

A Meta-Analysis of 46 Studies Identified by the FDA Demonstrates that Soy Protein Decreases Circulating LDL and Total Cholesterol Concentrations in Adults

Cardiovascular Events and Mortality in White Coat Hypertension: A Systematic Review and Meta-analysis

Limitation: Paucity of studies evaluating isolated cardiac outcomes or reporting participant race/ethnicity.
Conclusion:  Untreated WCH, but not treated WCE, is associated with an increased risk for cardiovascular events and all-cause mortality. Out-of-office BP monitoring is critical in the diagnosis and management of hypertension.
Read the abstract at Annals of Internal Medicine

Stress related disorders and risk of cardiovascular disease: population based, sibling controlled cohort study

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1255 (Published 10 April 2019) Cite this as: BMJ 2019;365:l1255

Conclusion Stress related disorders are robustly associated with multiple types of cardiovascular disease, independently of familial background, history of somatic/psychiatric diseases, and psychiatric comorbidity.

This study is Open Access and a PDF can be downloaded at the link above.