PARENTAL HISTORY OF HYPERTENSION AND PARENTAL HISTORY OF DIABETES ANDMICROVASCULAR COMPLICATIONS IN INSULIN-DEPENDENT DIABETES-MELLITUS - THE EURODIAB IDDM COMPLICATIONS STUDY

Diabetic nephropathy clusters in families, suggesting an inherited pre disposition. Parental history of hypertension and of Type 2 diabetes m ellitus have been associated with nephropathy in offspring with Type 1 diabetes in some studies but not in others. The associations of paren tal history of hypertension and of diabetes with both albuminuria and proliferative retinopathy were studied in a large cross-sectional stud y of 3250 patients with Type 1 diabetes, from 16 European countries. A lbuminuria was associated with hypertension in a parent (p < 0.01 in m en, p < 0.05 in women), adjusted for age. Patients with a parental his tory of hypertension had a higher prevalence of hypertension (p < 0.00 1 in men, p < 0.01 in women) and a higher prevalence of parental diabe tes (p < 0.001 in men, p < 0.001 in women). The association of albumin uria with parental hypertension was independent of parental diabetes i n men but not women (OR = 1.28 in men p = 0.04, OR = 1.25 in women p = 0.09) and was not independent of hypertension in the patient him/hers elf in either sex. Albuminuria was associated with parental diabetes i n women only (OR = 1.36, p = 0.04). This association was independent o f both parental hypertension and hypertension in the patient herself. Proliferative retinopathy was not associated with parental hypertensio n or diabetes. The implications of these data are that both candidate genes for hypertension and Type 2 diabetes should be considered in the search for the genetic determinants of diabetic nephropathy. (C) 1998 John Wiley & Sons, Ltd.