Prevalence of Diabetes and Cardiometabolic Disorders in Spouses of Diabetic Individuals

Sun, Jichao; Lu, Jieli; Wang, Weiqing; Mu, Yiming; Zhao, Jiajun; Liu, Chao; Chen, Lulu; Shi, Lixin; Li, Qiang; Yang, Tao; Yan, Li; Wan, Qin; Wu, Shengli; Liu, Yan; Wang, Guixia; Luo, Zuojie; Tang, Xulei; Chen, Gang; Huo, Yanan; Gao, Zhengnan; Su, Qing; Ye, Zhen; Wang, Youmin; Qin, Guijun; Deng, Hongkuan; Yu, Xuefeng; Shen, Feixia; Chen, Li; Zhao, Liebin; Bi, Yufang; Xu, Min; Xu, Yu; Dai, Meng; Wang, Tiange; Zhang, Di; Lai, Shenghan; Ning, Guang

doi:10.1093/aje/kwv330

Cited by 21 publications

(29 citation statements)

References 26 publications

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“…In addition to the couple status, nine factors, including personal and shared characteristics, of spousal concordance warrant attention. Most insured spouses were men who could have a higher risk of diabetes than their female counterparts [ 9 , 23 ]. The prevalence rate of diabetes was higher in insured spouses (18.41% in insured spouses versus 16.64% in dependent spouses), thus explicating the finding that insured men were more likely to experience spousal concordance of diabetes than were insured women ( Table 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…Various studies have reported genetic factors for diabetes mellitus [ 1 – 4 ], warranting its familial aggregation [ 5 – 8 ]. Nevertheless, few studies have investigated the clustering of diabetes [ 9 , 10 ], particularly in married couples who were not genetically related. A cross-sectional study on concordant diseases in couples revealed that the odds of diabetes concordance was significantly high after adjustment for age alone (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.06–2.74) but not after adjustment for age, smoking, and body mass index (OR = 1.41, 95% CI = 0.87–2.26) [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, age is considered a crucial determinant of diabetes. Studies have reported that old age is strongly associated with a high risk of diabetes [ 4 , 8 , 9 , 12 ]; the risk increases with age. Thus, middle-aged and elderly couples are susceptible to diabetes because of slowing metabolism and obesity.…”

Section: Introductionmentioning

confidence: 99%

“…Prior research has reported sex differences in the occurrence of diabetes. Men were more likely to be diagnosed as having hyperglycemia than are women, particularly men with an older age and habits of smoking and drinking [ 9 , 12 , 13 ]. A study indicated no significant association between income level and diabetes prevalence [ 14 ]; however, most studies have reported an association between income and diabetes, with low household income identified as the risk factor [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Investigating spousal concordance of diabetes through statistical analysis and data mining

et al. 2017

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ObjectiveSpousal clustering of diabetes merits attention. Whether old-age vulnerability or a shared family environment determines the concordance of diabetes is also uncertain. This study investigated the spousal concordance of diabetes and compared the risk of diabetes concordance between couples and noncouples by using nationally representative data.MethodsA total of 22,572 individuals identified from the 2002–2013 National Health Insurance Research Database of Taiwan constituted 5,643 couples and 5,643 noncouples through 1:1 dual propensity score matching (PSM). Factors associated with concordance in both spouses with diabetes were analyzed at the individual level. The risk of diabetes concordance between couples and noncouples was compared at the couple level. Logistic regression was the main statistical method. Statistical data were analyzed using SAS 9.4. C&RT and Apriori of data mining conducted in IBM SPSS Modeler 13 served as a supplement to statistics.ResultsHigh odds of the spousal concordance of diabetes were associated with old age, middle levels of urbanization, and high comorbidities (all P < 0.05). The dual PSM analysis revealed that the risk of diabetes concordance was significantly higher in couples (5.19%) than in noncouples (0.09%; OR = 61.743, P < 0.0001).ConclusionsA high concordance rate of diabetes in couples may indicate the influences of assortative mating and shared environment. Diabetes in a spouse implicates its risk in the partner. Family-based diabetes care that emphasizes the screening of couples at risk of diabetes by using the identified risk factors is suggested in prospective clinical practice interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Investigating spousal concordance of diabetes through statistical analysis and data mining

et al. 2017

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“…This increased risk has genetic and environmental components, the latter likely arising from shared risk factors such as sedentary lifestyle, physical inactivity and obesity [4]. Co-habiting partners are also at high risk from these shared risk factors [5]. Prevention studies in people at high risk provide compelling evidence that type 2 diabetes can be prevented or delayed with lifestyle modifications, such as increase in physical activity and healthy diet, and weight loss [6 -10].…”

Section: Introductionmentioning

confidence: 99%

Interventions for prevention of type 2 diabetes in relatives: A systematic review

Dimova

Mohan

Swanson

et al. 2017

Primary Care Diabetes

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The relatives and partners of people with type 2 diabetes are at increased risk of developing type 2 diabetes. This systematic review examines randomized controlled trials, written in English that tested an intervention, which aimed to modify behaviors known to delay or prevent type 2 diabetes, among the relatives or partners of people with type 2 diabetes. Study quality was assessed using the Cochrane Collaboration's tool for assessing risk of bias. Seven studies met the inclusion criteria. The majority of studies were at low risk of bias. Six studies tested an intervention in first-degree relatives of people with type 2 diabetes and one in partners. Intervention components and intervention intensity across studies varied, with those targeting diet and physical activity reporting the most significant changes in primary outcomes. Only one study did not observe significant changes in primary outcomes. There were three main recruitment approaches: advertising in the community, recruiting people through their relatives with diabetes, or identifying people as high risk by screening of their own health care contacts. Some evidence was found for potentially successful interventions to prevent type 2 diabetes among the relatives and partners of people with type 2 diabetes, although finding simple and effective methods to identify and recruit them remains a challenge. Future studies should explore the effect of patients' perceptions on their family members' behavior and capitalize on family relationships in order to increase intervention effectiveness.

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Spousal Concordance in the Development of Functional Limitations Among Married Adults in China

Wang

Hou

et al. 2021

JAMA Netw Open

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IMPORTANCE Functional limitation is increasingly common as people age and is often associated with negative consequences. Evidence of the dynamics of functional limitation within couples in China is still inadequate.OBJECTIVES To examine whether functional limitation was associated within middle-aged and older couples and to explore sex differences in spousal associations. DESIGN, SETTING, AND PARTICIPANTSIn this nationwide, population-based cohort study performed from January 1, 2011, to December 31, 2018, participants were selected using multistage probability sampling, and 5207 community-dwelling couples (10 414 individuals) 45 years or older were included in the nationally representative China Health and Retirement Longitudinal Study. Data analysis was performed from January 1 to February 28, 2021. EXPOSURESThe exposure variable was the presence of functional limitation in spouses. Functional limitation was measured by the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) scales and was defined as having difficulty in independently performing at least 1 ADL or IADL item. MAIN OUTCOMES AND MEASURESThe main outcome was functional limitation in index participants. Multivariable logistic regression with generalized estimating equations was used to estimate the reciprocal association of functional limitation within couples over time. RESULTS A total of 5207 married, different-sex couples (mean [SD] age, 59.1 [8.8] years for husbands and 57.0 [8.2] years for wives) were included in the study. For husbands, the number (percentage) of participants classified with baseline functional limitation was 1140 (21.9%), the number (percentage) with ADL limitation was 684 (13.1%), and the number (percentage) with IADL limitation was 834 (16.0%). For wives, the number (percentage) of participants classified with baseline functional limitation was 1502 (28.8%), the number (percentage) with ADL limitation was 887 (17.0%), and the number (percentage) with IADL limitation was 1183 (22.7%). Longitudinal results demonstrated an association in spouses developing functional limitation (adjusted odds ratio[OR], 2.55; 95% CI, 2.41-2.69; P < .001), ADL limitation (adjusted OR, 2.26; 95% CI, 2.11-2.41; P < .001), and IADL limitation (adjusted OR, 2.58; 95% CI, 2.43-2.73; P < .001). Subgroup analyses by sex revealed similar patterns of spousal health concordance in terms of all studied outcomes, indicating no sex specificity. CONCLUSIONS AND RELEVANCE This population-based cohort study suggests that amongChinese middle-aged and older couples there is significant concordance in the development of functional limitation. This study of spousal functional ability from a dyadic perspective may help in (continued) Key Points Question Are spouses concordant in the development of functional limitation over time in middle and old age? Findings In this cohort study of 10 414 community-dwelling participants (5207 married, different-sex couples) 45 years or older in China, significant interdependent associations were ...

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Prevalence of Diabetes and Cardiometabolic Disorders in Spouses of Diabetic Individuals

Cited by 21 publications

References 26 publications

Investigating spousal concordance of diabetes through statistical analysis and data mining

Investigating spousal concordance of diabetes through statistical analysis and data mining

Interventions for prevention of type 2 diabetes in relatives: A systematic review

Spousal Concordance in the Development of Functional Limitations Among Married Adults in China

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