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Parental Alcohol Problems, Parental Divorce, and Type 2 Diabetes in Adulthood: A Longitudinal Prospective Cohort
Subina Upadhyaya1, Tommi Tolmunen, Antti-Pekka Elomaa
1From the Research Centre for Child Psychiatry (Upadhyaya), University of Turku, Turku; Department of Psychiatry (Tolmunen), Kuopio University Hospital; Department of Neurosurgery (Elomaa), Kuopio University Hospital; Institute of Clinical Medicine/Psychiatry (Tolmunen, Ruohomäki, Kraav) and Department of Social Sciences (Kraav), University of Eastern Finland, Kuopio, Finland; School of Medicine (Kauhanen), Vilnius University, Vilnius, Lithuania; Center for Social Epidemiology and Population Health (Kaplan), University of Michigan, Ann Arbor, Michigan; Institute for Integrative Health (Kaplan), Baltimore, Maryland; Institute of Public Health and Clinical Nutrition (Kauhanen), University of Eastern Finland, Kuopio, Finland; Institute of Clinical Medicine (Lehto), University of Oslo, Oslo; R&D Department, Division of Mental Health Services (Lehto), Akershus University Hospital, Lørenskog, Norway; and Department of Psychiatry (Lehto), University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Objective:
Type 2 diabetes is a chronic disease and a serious global public health concern increasing both mortality and morbidity. Previous studies have found evidence for an association between early psychological stress and diabetes later in life.
Methods:
This study examined the association between parental alcohol problems and parental divorce and the incidence of type 2 diabetes in Finnish men aged 42 to 61 years (n = 754) in a prospective setting. Information on parental alcohol problems and parental divorce was derived from school records and subjective experiences of the same events from self-rated questionnaires. The average follow-up time for the participants until the first type 2 diabetes diagnosis was 23.3 years (25th-75th percentile, 21.2-27.9 years).
Results:
Cox regression analyses revealed that parental alcohol problems (hazard ratio = 3.09, 95% confidence interval = 1.38-6.88) were associated with an increased risk of type 2 diabetes during the follow-up, even after adjustment for age, marital status, education, Human Population Laboratory Depression Scale scores, smoking, alcohol consumption, body mass index, and serum high-sensitivity C-reactive protein. In a similar model, parental divorce (hazard ratio = 1.69, 95% confidence interval = 0.40-7.05) was not associated with an increased risk of type 2 diabetes during the follow-up.
Conclusions:
Our findings suggest that not all adverse childhood experiences contribute equally to the risk of type 2 diabetes. Parental alcohol problems, but not parental divorce, were associated with an increased risk of type 2 diabetes in men. These findings highlight the need for early interventions targeting parents with excessive alcohol consumption to reduce their offspring's risk of life-style-related disorders.
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