Parental history of diabetes modifies the association between abdominal adiposity and hyperglycemia

To examine whether the association between abdominal obesity and hyperglycemia differs according to the presence of a parental history of diabetes.

We conducted a cross-sectional study of 3,068 men and women, aged 20-65 years, without known diabetes who were fasting participants of a population-based study in three Dutch towns. Hyperglycemia was defined as a fasting plasma glucose concentration of 6.1 mmol/l (American Diabetes Association criterion). Waist circumference was categorized according to previously defined waist action levels. All estimates were adjusted for age and town.

The regression coefficients for the association between waist circumference and fasting plasma glucose were larger in participants who had a parental history of diabetes than in those who did not (men beta = 0.31 vs. 0.16 mmol/SD, P [for interaction] = 0.003; women beta = 0.24 vs. 0.11 mmol/SD, P = 0.002). Furthermore, larger waist circumference (men > or = 94 vs. < 94 cm, women > or = 88 vs. < 80 cm) was associated with a greater excess prevalence of hyperglycemia in participants who had a parental history of diabetes than in those who did not (men 12.4 vs. 2.0%, P = 0.03; women 13.6 vs. 5.9%, P = 0.05). Adjustment for physical activity, alcohol intake, smoking, and educational level did not materially change the results.

These findings indicate that the association between abdominal obesity and hyperglycemia is stronger in the presence of a parental history of diabetes. Blood glucose screening may be warranted at lower levels of waist circumference in individuals with a parental history of diabetes.