Abstract
BackgroundTwins may be at increased risk of dysglycaemic disorders due to adverse fetal conditions. Data from Africa regarding this association is limited. We studied impaired glucose tolerance (IGT) and other types of dysglycemia among twins and singletons in Guinea-Bissau.MethodsThe study was conducted from February 2011 until March 2012 at the Bandim Health Project, a health and demographic surveillance system site in the capital Bissau. Twins (n = 209) and singletons (n = 182) were recruited from a previously established cohort. Oral glucose tolerance tests (OGTT) were performed, along with anthropometrics and collection of clinical and dietary data.ResultsMedian age was 16.6 and 14.2 years between twins and singletons, respectively (P = 0.08). Mean birth weight was 2410 vs. 3090 g, respectively (P < 0.001). Twins had higher median fasting- and two hour capillary plasma glucose, 5.4(3.2–8.2) vs. 5.0(3.2–11.5) mmol/L (P < 0.001) and 6.8(3.4–11.3) vs. 6.2(3.2–12.1) mmol/L (P < 0.001), respectively, compared to singletons. The prevalence of IGT was 2.5 % (5/209) vs. 3.5 % (6/182) (RR = 0.73, 95 % CI: 0.20–2.64). 12 % (25/209) of twins had impaired fasting glucose (IFG), compared to 3.5 % (6/182) of singletons (3.63, 1.53–8.62). Dysglycemia (IGT and/or IFG or overt diabetes) was found in 17 % (35/209) vs. 9 % (16/182) (1.90, 1.08–3.37), respectively.ConclusionsTwins had higher glucose levels in both the fasting and postprandial state. This may indicate a detrimental effect of the twin fetal environment on glucose metabolism later in life, a result contrary to Scandinavian register studies. The IGT burden was low in this young age group and the risk was similar in twins and singletons.Electronic supplementary materialThe online version of this article (doi:10.1186/s12902-016-0126-6) contains supplementary material, which is available to authorized users.
Highlights
Twins may be at increased risk of dysglycaemic disorders due to adverse fetal conditions
Twins had higher glucose levels in both the fasting and postprandial state. This may indicate a detrimental effect of the twin fetal environment on glucose metabolism later in life, a result contrary to Scandinavian register studies
The impaired glucose tolerance (IGT) burden was low in this young age group and the risk was similar in twins and singletons
Summary
Twins may be at increased risk of dysglycaemic disorders due to adverse fetal conditions. As twins are frequently born with LBW, they may be at higher risk of developing metabolic diseases related to glucose homeostasis, compared to singletons [7] Such an association would be of great interest in Sub-Saharan Africa, where twinning is common [8] and the DM prevalence is increasing rapidly [9, 10]. Clinical studies from Denmark showed that twins had a higher burden of insulin resistance and abdominal obesity [7], while an Italian study observed a higher rate of metabolic syndrome [11] Another Danish population based study showed an increased risk of type 2 DM in elderly Danish twins [12]. A large scale Danish register study did, not find a higher DM burden among twins [13], a finding replicated later in a Swedish register study [14]
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