Family history of diabetes in first-degree relatives and risk of hand surgical diagnoses: a Swedish population-based cohort study from the Malmö Diet and Cancer Study
Lovisa Lesand, Mattias Rydberg, Peter Nilsson, Lars B Dahlin, Malin ZimmermanObjectives
Diabetes mellitus (DM) has a strong genetic component and is a known risk factor for several hand conditions. We aimed to examine whether DM in first-degree relatives is associated with an increased risk of hand surgical diagnoses.
Design
A retrospective cohort study.
Setting
Data were collected from a population-based cohort in southern Sweden (Malmö Diet and Cancer Study (MDCS)). Family relationships were obtained through the Swedish Multi-Generation Register and healthcare diagnoses from the National Patient Register.
Participants
30 446 individuals (60% female) aged 45–73 years were included from the MDCS.
Outcome measures
The primary outcome was any diagnosis within the ‘diabetic hand’ category; carpal tunnel syndrome, ulnar nerve entrapment, trigger finger, Dupuytren’s disease and thumb base osteoarthritis, identified through International Classification of Diseases, tenth revision codes. Logistic regression models were used.
Results
In the index study population, 4 150 (14%) had ≥1 hand surgical diagnosis. In unadjusted models, DM in the index individual and first-degree relatives was associated with an increased risk of developing hand surgical diagnoses (OR 1.14, 95% CI 1.06 to 1.22). After adjusting for confounders, only DM in the index individual remained significantly associated with the diabetic hand (OR 1.23, 95% CI 1.13 to 1.33). In diagnosis-specific analyses, an association persisted between having ≥1 sibling with DM and Dupuytren’s disease (OR 1.39, 95% CI 1.09 to 1.76), and between having ≥1 child with DM and carpal tunnel syndrome (OR 1.18, 95% CI 1.00 to 1.39).
Conclusion
While DM in the index individual was consistently associated with a higher risk of multiple hand surgical diagnoses, DM in first-degree relatives did not significantly influence the risk after adjustments. Exceptions included an association between ≥1 sibling with DM and Dupuytren’s disease, and ≥1 child with DM and carpal tunnel syndrome. Future research should further explore potential genetic factors contributing to these conditions.