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.
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OBJECTIVES: 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.