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The Impact of Spousal Diabetes Status and Ideal Cardiovascular Health Metrics on Risk of Incident Diabetes: A Nationwide Prospective Cohort Study
33 Pages Posted: 27 Dec 2022More...
Background: Pairs of spouses share common socio-economic, environmental and lifestyle factors. Multiple studies found that spousal diabetes status was related to diabetes prevalence. We explored the influence of spousal diabetes status and cardiovascular health metrics on risk of incident diabetes in a prospective cohort study.
Methods: The study participants were from a population-based cohort which called China Cardiometabolic Disease and Cancer Cohort and followed up for 3.6 years. 34821 non-diabetes individuals who have completed their own and spouse's glucose information were involved in the study. Diabetes was defined according to 2010 American Diabetes Association standard criteria.
Findings: Spousal diabetes diagnosis was associated with increased risk of incident diabetes (HR=1.246 95%CI: 1.111-1.397). Further, participants whose spouses with uncontrolled HbA1c level had higher risk of diabetes (HR=1.299 95%CI: 1.121-1.504) and the risk of diabetes disappeared in the participants whose spouses with controlled HbA1c level (HR=1.180 95%CI: 0.996-1.399). Moreover, individuals whose ideal cardiovascular health metrics (ICVHM) value was less than 4 were affected by their spouse's diabetes status, while individuals whose ICVHM value was 4 or more were not affected. Besides, those who had more components of ICVHMs than their spouses could avoid increase of diabetes risk associated with spouses’ diabetes diagnosis.
Interpretation: Spousal diabetes status with uncontrolled HbA1c level is an independent risk factor of individual diabetes, but strict management of spouse's HbA1c level and improving ICVHM profiles can prevent adverse effects of spousal diabetes status on diabetes risk.
Funding: National Natural Science Foundation of China (82070880, 81500660, 81870560, 81970728, 82022011, 81941017, 81970706), the Shanghai Municipal Government (18411951800), the Shanghai Shen Kang Hospital Development Center (SHDC12019101, SHDC2020CR1001A, SHDC2020CR3064B), the Program for Professor of Special Appointment (Younger Eastern Scholar) at Shanghai Institutions of Higher Learning (No.QD2016007), Innovative research team of high-level local universities in Shanghai, and the Shanghai Municipal Education Commission–Gaofeng Clinical Medicine Grant Support (20161307 and 20152508 Round 2), Shanghai Clinical Research Center for Metabolic Disease (19MC1910100).
Declaration of Interests: The authors declare that they have no competing interests.
Ethics Approval Statement: The study protocol and informed consent were approved by the Committee on Human Research at Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. All participants signed the written informed consent.
Keywords: Spouses, diabetes, previously diagnosed, uncontrolled, Ideal Cardiovascular Health Metrics
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