Sex differences in the association between spousal metabolic risk factors with incidence of type 2 diabetes: a longitudinal study of the Iranian population

Ramezankhani, Azra; Guity, Kamran; Azizi, Fereidoun; Hadaegh, Farzad

doi:10.1186/s13293-019-0255-5

Cited by 8 publications

(14 citation statements)

References 26 publications

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“… 12 14 Further research is needed to ascertain whether this can be explained by differences between the study populations or by other factors, such as the limitations discussed below. Additionally, some cohort studies conducted in the Middle East have generated different results: having a wife with diabetes did not significantly increase her husband’s risk of diabetes, 19 and having a spouse with hypertension did not increase the risk of hypertension. 20 The establishment of a cohort study in Japan would allow us to evaluate this issue in more detail.…”

Section: Discussionmentioning

confidence: 98%

“…There have been several previous studies of the spousal concordance of disease, [12][13][14][15][16][17][18][19][20] and it has been posited that the degree of spousal concordance depends on the community being studied. 16 In Japan, to the best of our knowledge, no studies have been conducted using nationally representative data regarding the spousal concordance of hypertension, diabetes or dyslipidaemia.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

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Concordance of hypertension, diabetes and dyslipidaemia in married couples: cross-sectional study using nationwide survey data in Japan

Watanabe

Sugiyama²,

Takahashi

et al. 2020

BMJ Open

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ObjectiveBecause married couples have many environmental influences in common, spouses may develop similar diseases. This study aimed to determine the concordance of hypertension, diabetes and dyslipidaemia, which are major risk factors for cardiovascular disease, among married couples in Japan.Research design and methodsWe conducted a cross-sectional study of married couples who were both aged ≥40 years using the 2016 Comprehensive Survey of Living Conditions, which is a Japanese national survey. We first determined the proportions of wives and husbands who were receiving therapy for each of the diseases of interest. We then conducted logistic regression analyses using the wives undergoing therapy for each disease as outcomes and the husbands undergoing therapy for the same disease as the principal exposure, adjusting for covariates.ResultsThe subjects of the analyses were 86 941 married couples. The wives of male patients were significantly more likely to be receiving therapy for the same disease. Logistic regression revealed that when husbands were undergoing therapy for these diseases their wives had ORs (95% CIs) of 1.79 (1.72–1.86) for hypertension, 1.45 (1.34–1.58) for diabetes, 2.58 (2.41–2.75) for dyslipidaemia and 1.87 (1.80–1.93) for any of these diseases.ConclusionsIf men have hypertension, diabetes or dyslipidaemia, their wives were also more susceptible to the same disease. Medical professionals and couples may need to recognise these results and consider couple-based interventions to help the prevention, early detection and treatment of these diseases.

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Section: Discussionmentioning

confidence: 98%

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Concordance of hypertension, diabetes and dyslipidaemia in married couples: cross-sectional study using nationwide survey data in Japan

Watanabe

Sugiyama²,

Takahashi

et al. 2020

BMJ Open

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“…16 Our results have important implications for both public health practitioners and health care professionals. However, the association was stronger for men than for women.…”

Section: Discussionmentioning

confidence: 86%

“…In fact, we have also observed a sex difference in our previous study in which spousal DM was associated with 23% higher risk of DM among women, but not among men. 16 Our results have important implications for both public health practitioners and health care professionals. Current screening programmes and prevention strategies focus predominantly on individuals risk factors to identify people who are at high risk of developing hypertension.…”

Section: Discussionmentioning

confidence: 86%

Spousal metabolic risk factors and incident hypertension: A longitudinal cohort study in Iran

Ramezankhani

Guity

Azizi

et al. 2019

J of Clinical Hypertension

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Hypertension is a major global health challenge, affecting more than 1 billion people worldwide, and this is projected to increase in 1.56 billion by 2025. 1,2 Uncontrolled hypertension is currently an important contributor for heart disease, stroke, kidney failure, and premature mortality. 3,4 Globally, hypertension is responsible for 13% of premature deaths in developed and developing countries. 3,5 According to an Iranian national survey in 2011, 25.6% of adults, aged 25-70 years, had hypertension. 6 Also, the crude incidence rate of hypertension was 33.6 per 1000 person-years in Iranian population, over a decade long follow-up. 7 A wide variety of genetic and environmental factors predispose individuals to hypertension; although, contribution of genetic factors has been shown to be small. 8 According to available evidence, a number of lifestyle behaviors including, smoking, diabetes, being obese or overweight, high cholesterol, excess salt intake, and physical inactivity play a greater role in developing hypertension. 9,10 Therefore, early detection of individuals at high risk for hypertension and proper management of these modifiable risk factors is important for primary prevention of hypertension. 9 One approach to investigate the contribution of environmental factors in disease development is study of cohabiting couples because such spouses usually are not genetically related but share a common living environment, pool resources, eat together, and share a social network. 11,12 A large number of epidemiological studies demonstrated significant positive spousal concordance for diabetes mellitus (DM), 13-16 and the majority of main coronary risk factors including diastolic blood pressure (DBP), triglycerides (TG), total and low-density lipoprotein cholesterol (TC and LDL-C), AbstractWe investigated the association between metabolic risk factors in one spouse with incident hypertension in the other. Study sample included 1528 men and 1649 women aged ≥20 years from the Tehran lipid and glucose study with information on body mass index (BMI), waist circumference (WC), hypertension, type 2 diabetes mellitus (DM), and dyslipidemia. The hazard ratio (HR) and 95% confidence interval (95% CI) were estimated for the association of spousal metabolic factors and incident hypertension among men and women separately. A total of 604 and 566 cases of incident hypertension were observed in men and women, respectively. Among men, spousal DM was associated with a 40% (CI: 1.07-1.83) excess risk of hypertension after adjusting for the men's own and their spouse's risk factors including BMI, DM, smoking, and physical activity level. Among women, spousal DM was associated with more than two times (2.11, 1.69-2.63) higher risk of hypertension. After further adjustment for the women's own and their spouse's risk factors, the association was attenuated and remained marginally significant (1.25, 0.99-1.58; P value = .053).Having a spouse with DM increases an individual's risk of hypertension, which raises the possibility of using pre...

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“…Several cross-sectional studies on spousal concordance have been conducted in chronic diseases, including hypertension (23,24), cardiovascular diseases (25)(26)(27), cancers (28), and type 2 diabetes (29), which may be explained by the shared environment (22). In Iran, the spousal concordance for type 2 diabetes and hypertension has been previously shown in cross-sectional studies (30,31).…”

Section: Introductionmentioning

confidence: 93%

Predictive Value of Women’s Weight Trajectories in Determining Familial Cardiovascular Disorders: A Family Based Longitudinal Study

Naseri

Amiri

Zareie-Shabkhaneh

et al. 2020

Preprint

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Background: Considering dynamic nature of body mass index (BMI) in women, is crucial to determine cardiovascular risks in both individual and familial levels. This study aimed to investigate the life-course trajectory pattern of women's BMI and its association with cardiovascular risk factors in them and their family members. Methods: Based on the Tehran Lipid and Glucose Study (TLGS), a total of 1356 mothers with 2976 children (51.8 % girls) aged ≤ 18 years at baseline were recruited in the current analysis and followed up for an average period of 15 years. Cardiovascular risk factors, including hypertension (HTN), dyslipidemia, diabetes mellitus (DM), and obesity were considered as outcome variables. Latent growth curve modelling (LGCM) was applied to determine women's BMI trajectories; then, logistic regression was used to investigate the associations between trajectory patterns of women and cardiovascular risk factors among whole family members.Results: Women were classified into three trajectory groups labeled as normal, overweight, and obese. Compared to women's in the normal trajectory group, those in the overweight and obesity trajectory groups had higher odds ratios for HTN, DM, and dyslipidemia (p < 0.05). In the final model, men with obese spouses showed a higher rate of HTN 1.54 (95% CI: 1.05-2.25) and DM 1.55; (95% CI: 1.00–2.44). The odds of men's obesity were higher in their obese spouses compared to normal weight ones, and the odds ratios were (OR=1.70; 95%CI: 1.10-2.62). Offspring of obese and overweight mothers were more likely to be obese than those whose mothers were normal weight. The odds ratios were (OR=2.39; 95%CI: 1.67-3.44) and (OR=4.81; 95%CI: 3.16-7.34) respectively. The corresponding value for dyslipidemia in offspring with obese mothers were 1.39 (95% CI: 1.00-1.94). Conclusions: Our results showed that women's weight status over time, play a critical role in determining cardiovascular risk, not only in them but also in their family members. The current results emphasized paying more attention to women with excessive weight to promote familial cardiovascular health in the communities.

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Sex differences in the association between spousal metabolic risk factors with incidence of type 2 diabetes: a longitudinal study of the Iranian population

Cited by 8 publications

References 26 publications

Concordance of hypertension, diabetes and dyslipidaemia in married couples: cross-sectional study using nationwide survey data in Japan

Concordance of hypertension, diabetes and dyslipidaemia in married couples: cross-sectional study using nationwide survey data in Japan

Spousal metabolic risk factors and incident hypertension: A longitudinal cohort study in Iran

Predictive Value of Women’s Weight Trajectories in Determining Familial Cardiovascular Disorders: A Family Based Longitudinal Study

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