Family history of diabetes tied to higher risk of CFRD in CF adults: Study
Researchers urge clinicians to obtain health info to identify at-risk patients
Written by |
Having a family history of diabetes may significantly increase the risk of developing cystic fibrosis-related diabetes (CFRD), a common complication of cystic fibrosis (CF), according to a new U.S. study.
The researchers found that adults with CF who had a family history of diabetes, particularly type 2 diabetes, were more than twice as likely to develop CFRD compared with those without such a history. A family history of CFRD itself nearly doubled the odds of developing the condition.
“Clinicians should obtain diabetes family health information in CF,” researchers wrote, noting that such information may help identify at-risk patients and guide earlier monitoring and intervention.
The study, “Evaluation of Family History of Diabetes and the Development of CFRD in a Clinical Cystic Fibrosis Cohort,” was published in the journal Endocrine Practice.
CFRD is second-most common complication of CF
CF is caused by mutations in the CFTR gene, which encodes a protein of the same name that regulates the movement of salt and water in and out of cells. When CFTR does not function properly, thick, sticky mucus builds up in organs such as the lungs and pancreas, leading to disease symptoms.
After pancreatic insufficiency — a condition in which the pancreas cannot produce enough digestive enzymes — CFRD is the most common complication of CF, affecting up to half of adults older than 40. Known risk factors for CFRD include older age, female sex, lower body mass index (BMI, a measure of body fat based on height and weight), pancreatic insufficiency, and more severe CFTR gene mutations.
Although a family history is a well-established risk factor for type 2 diabetes, the most common form of the condition marked by high blood sugar levels, “the influence of familial diabetes on CFRD risk remains uncertain,” the researchers wrote.
Previous studies have shown mixed results, with some suggesting that a family history of type 2 diabetes increases CFRD risk, while others have not consistently evaluated this factor. The researchers also noted that there is no standardized way to collect diabetes family history in adults with CF, as such data in electronic health records are often incomplete.
Patients with family history of diabetes 2.6 times more likely to get CFRD
To address this, a team of U.S. researchers retrospectively analyzed clinical data from 343 adults with CF. Data were drawn from the University of Utah Adult CF Center Family History Quality Improvement project, which systematically collected detailed, structured information on patients’ family histories of diabetes.
CFRD was present in 123 participants (35.9%). Overall, patients with CFRD tended to be male, older, and have a higher prevalence of pancreatic insufficiency. They also had higher blood sugar levels and were more likely to report a family history of diabetes than those without CFRD (77% vs. 60%).
Further analysis showed that a family history of diabetes was associated with a significantly higher likelihood of developing CFRD. After adjusting for other factors, individuals with a positive family history had 2.6 times higher odds of developing CFRD compared with those without such a history.
Our results indicate that systematic collection of diabetes family history information is practical and can be completed as part of standard practice. Familial diabetes information could inform personalized CFRD screening strategies by integrating family health history into risk models, enabling earlier detection and personalized prevention for [people with CF]./quote]
More detailed analyses showed that having relatives with type 2 diabetes was associated with a 51% higher risk of CFRD compared with those without a family history of type 2 diabetes. But the risk was 2.6 times higher when people with a family history of type 2 diabetes were compared with those with no family history of any type of diabetes.
A family history of CFRD itself was also linked to a 92% higher risk of developing the condition. In contrast, having no family history of diabetes appeared to be protective.
Other known risk factors were also confirmed. Pancreatic insufficiency was associated with nearly fourfold higher odds of CFRD, while each additional decade of age increased the risk by 46%. In contrast, sex, BMI, and type of CFTR gene mutation were not significantly associated with CFRD.
“Our results indicate that systematic collection of diabetes family history information is practical and can be completed as part of standard practice,” the researchers wrote. “Familial diabetes information could inform personalized CFRD screening strategies by integrating family health history into risk models, enabling earlier detection and personalized prevention for [people with CF].”
