Early-life background and the development of non-insulin-dependent diabetes mellitus

The relationship of early-life background factors to type 2, or non-insulin-dependent, diabetes mellitus (NIDDM) was examined with reference to family history of diabetes in two groups of Nisei (U.S. born/raised Japanese American) men from King County, Washington with identical mean (+/- S.E.M.) ages: 78 with NIDDM, 61.6 (+/- 0.7) years of age; and 79 with normal glucose tolerance (NGT), 61.6 (+/- 0.6) years of age. The early-life variables were birthplace, parents' education, father's occupation and mother's employment status during subject's childhood, sibship size, son birth order, physical activity and weight assessed for ages 15-20 years, and educational achievement. Multivariate logistic regression models were used to test for the effect of each variable on the risk for diabetes in the presence of other variables. Results are presented as odds ratios (OR) with 95% confidence intervals (CI). Significantly higher risk for NIDDM was found with urban birthplace (vs. rural, OR = 2.09, 95% CI = 1.37-3.19), parents' education above primary level (vs. primary level or less, OR = 1.64, 95% CI = 1.08-2.50), mother being employed (vs. housewife, OR = 2.17, 95% CI = 1.43-3.45), subject being less active-lean as a youth (vs. more active-lean, OR = 1.69, 95% CI = 1.11-2.63), and subject's not attaining a college degree (vs. college degree, OR = 2.17, 95% CI = 1.41-3.33). In separate analyses of the early-life variables by family history of diabetes, the interplay of environmental influences with familial predisposition to NIDDM is evident. The developmental background of NIDDM is discussed with reference to the concept of phenotype amplification within the context of the effects of westernization.