Published online September 1, 2007
PEDIATRICS Vol. 120 Supplement September 2007, pp. S78-S86 (doi:10.1542/peds.2007-1010G)
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SUPPLEMENT ARTICLE


Is Family History a Useful Tool for Detecting Children at Risk for Diabetes and Cardiovascular Diseases? A Public Health Perspective

Rodolfo Valdez, PhD, MSca, Kurt J. Greenlund, PhDb, Muin J. Khoury, MD, PhDa and Paula W. Yoon, ScD, MPHa

a National Office of Public Health Genomics
b Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

Several studies indicate that the risk for type 2 diabetes or cardiovascular disease is detectable in childhood, although these disorders may not emerge until adulthood. In addition, type 2 diabetes and cardiovascular disease seem to share risk factors, including obesity and dyslipidemia, and might even share etiology, which has important implications for screening and prevention strategies for both diseases. Primary prevention, in particular, has gained importance because the results of major randomized, controlled trials strongly suggest that, at least in high-risk adult groups, type 2 diabetes can be prevented or delayed. Furthermore, some intervention studies indicate that the risk factors for diabetes and cardiovascular disease can be reduced in children. A simple way to detect risk for either diabetes or cardiovascular disease is to examine the family history. Numerous studies have shown that adults who have 1 or more first- or second-degree relatives affected with diabetes or cardiovascular disease are at high risk of having or developing these diseases. Currently, there are no overall screening strategies recommended for either diabetes or cardiovascular disease among children and adolescents. The evidence is strong, however, that youth with a positive family history already show signs of increased risk for these conditions. Family history can be part of the approach to screening for children at risk of diabetes and cardiovascular disease and should be part of prevention campaigns aimed at reducing the burden of these diseases and their risk factors in children.

Key Words: family history • diabetes • heart disease • cardiovascular diseases

Abbreviations: CVD—cardiovascular disease • BP—blood pressure • SBP—systolic blood pressure • DBP—diastolic blood pressure • LDL—low-density lipoprotein • HDL—high-density lipoprotein • CHD—coronary heart disease

Accepted May 16, 2007.