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Meta-Analysis
. 2019 Jun;56(6):619-629.
doi: 10.1007/s00592-019-01311-y. Epub 2019 Mar 19.

Spousal diabetes status as a risk factor for incident type 2 diabetes: a prospective cohort study and meta-analysis

Duke Appiah  1 , Pamela J Schreiner  2 , Elizabeth Selvin  3 , Ellen W Demerath  2 , James S Pankow  2
Affiliations
Meta-Analysis

Spousal diabetes status as a risk factor for incident type 2 diabetes: a prospective cohort study and meta-analysis

Duke Appiah et al. Acta Diabetol. 2019 Jun.

Abstract

Aims: It is unclear if the presence of type-2 diabetes in one spouse is associated with the development of diabetes in the other spouse. We studied the concordance of diabetes among black and white participants in the Atherosclerosis Risk in Communities (ARIC) study and summarized existing studies in a meta-analysis.

Methods: We conducted a prospective cohort analysis of ARIC data from 8077 married men and women (mean age 54 years) without diabetes at baseline (1987-1989). Complementary log-log models that accounted for interval censoring was used to model the hazard ratio (HR) for the association of spousal diabetes status with the incidence of diabetes. For the meta-analysis, we searched MEDLINE and EMBASE for observational studies published through December 2018 that evaluated spousal concordance for diabetes.

Results: During a median follow-up of 22 years, 2512 incident cases of diabetes were recorded. In models with adjustment for general adiposity, spousal cardiometabolic factors and other diabetes risk factors, adults who had a spouse with diabetes had elevated risk for incident diabetes compared to those without a spouse diagnosed with diabetes (HR 1.20, 95% confidence interval 1.02-1.41). This association did not differ by sex or race. Summarized estimates from the 17 studies (489,798 participants from 9 countries) included in the meta-analysis showed a positive association between spousal diabetes status and the development of diabetes (Pooled odds ratio 1.88, 95% CI 1.52-2.33).

Conclusions: Results from this large prospective biracial cohort and meta-analysis provides evidence that spouses of persons with diabetes are a high-risk group for diabetes.

Keywords: Concordance; Epidemiology; Longitudinal; Obesity; Spouse; Type 2 diabetes.

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Conflict of interest statement

Conflict of interest

The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of study selection for the meta‐analysis
Fig. 2
Fig. 2
Forest plot of odds ratios and 95% CIs for the association of spousal diabetes status with the development of diabetes in the non-diabetes spouse. Appiah et al is the current study
See this image and copyright information in PMC

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