Abstract
BackgroundDiabetes history in biologically-related individuals increases diabetes risk. We assessed diabetes concordance in spouses (that is, biologically unrelated family members) to gauge the importance of socioenvironmental factors.MethodsWe selected cross-sectional, case–control and cohort studies examining spousal association for diabetes and/or prediabetes (impaired fasting glucose or impaired glucose tolerance), indexed in Medline, Embase or Scopus (1 January 1997 to 28 February 2013). Effect estimates (that is, odds ratios, incidence rate ratios, and so on) with body mass index (BMI) adjustment were pooled separately from those without BMI adjustment (random effects models) to distinguish BMI-dependent and independent concordance.ResultsSearches yielded 2,705 articles; six were retained (n = 75,498 couples) for systematic review and five for meta-analysis. Concordance was lowest in a study that relied on women’s reports of diabetes in themselves and their spouses (effect estimate 1.1, 95% CI 1.0 to 1.30) and highest in a study with systematic assessment of glucose tolerance (2.11, 95% CI 1.74 to 5.10). The random-effects pooled estimate adjusted for age and other covariates but not BMI was 1.26 (95% CI 1.08 to 1.45). The estimate with BMI adjustment was lower (1.18, 95% CI 0.97 to 1.40). Two studies assessing between-spouse associations of diabetes/prediabetes determined by glucose testing reported high concordance (OR 1.92, 95% CI 1.55 to 2.37 without BMI adjustment; 2.32, 95% CI 1.87 to 3.98 with BMI adjustment). Two studies did not distinguish type 1 and type 2 diabetes. However given that around 95% of adults is type 2, this is unlikely to have influenced the results.ConclusionsOur pooled estimate suggests that a spousal history of diabetes is associated with a 26% diabetes risk increase. Recognizing shared risk between spouses may improve diabetes detection and motivate couples to increase collaborative efforts to optimize eating and physical activity habits.
Highlights
Diabetes history in biologically-related individuals increases diabetes risk
Two focused on East Asian populations (China [20]; Korea [37]); two were from the United Kingdom [36,38] and included an ethnocultural mix in which more than half were Europid and the remainder were of South Asian, East Asian or African origin; one study examined naturalized Hispanics in the United States (US) [35]; and one study was from Sweden [9]
Results of individual studies Effect estimates for associations of spousal diabetes history with prevalent diabetes, adjusted for age and other covariates but not body mass index (BMI), varied from as low as 10% (OR 1.1) in the Shanghai-based study by Jurj and colleagues [20] to approximately 70% (OR 1.70) in the Trent UK general practice study by Hippisley-Cox and colleagues [36] and in the American Southwest study on a Hispanic population by Stimpson and colleagues [35]
Summary
Diabetes history in biologically-related individuals increases diabetes risk. We assessed diabetes concordance in spouses (that is, biologically unrelated family members) to gauge the importance of socioenvironmental factors. Diabetes history in biologically-related family members is a key component of the diabetes risk assessment [7,8]. The heritability of type 2 diabetes is estimated at approximately 25% [10,11]. More than 60 common genetic variants implicated in the disease have been identified through genome-wide association studies. Their added effects explain less than 10% of the heritability of type 2 diabetes [12,13,14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
