Concordance of glycaemic and cardiometabolic traits between Indian women with history of gestational diabetes mellitus and their spouses: an opportunity to target the household
The aim of this study was to investigate the concordance of dysglycaemia (prediabetes or diabetes) and cardiometabolic traits between women with a history of gestational diabetes mellitus (GDM) and their spouses.
Using hospital medical records, women with GDM (diagnosed between 2012 and 2016) and their spouses were invited to participate in the study and to attend a scheduled hospital visit in a fasting state. Sociodemographic, anthropometric and medical data were collected, and a 75 g OGTT with serum insulin estimation, HbA1c measurement and fasting lipid profile were performed at the visit. Prediabetes and diabetes were defined using ADA criteria and the metabolic syndrome was defined using IDF criteria.
A total of 214 couples participated in the study. Women were tested at a mean ± SD age of 32.4 ± 4.6 years and median (quartile [q]25–q75) of 19.5 (11–44) months following the index delivery, while men were tested at a mean ± SD age of 36.4 ± 5.4 years. A total of 72 (33.6%) couples showed concordance for dysglycaemia, while 99 (46.3%) and 51 (23.8%) couples were concordant for overweight/obesity and the metabolic syndrome, respectively. A total of 146 (68.2%) couples showed concordance for any of the above three factors. The presence of dysglycaemia in one partner was associated with an increased risk of dysglycaemia in the other partner (OR 1.80 [95% CI 1.04, 3.11]). Similarly, being overweight/obese (OR 2.19 [95% CI 1.22, 3.93]) and presence of the metabolic syndrome (OR 2.01 [95% CI 1.16, 3.50]) in one partner was associated with an increased risk of these conditions in the other partner. Both women and men were more likely to have dysglycaemia if they had a partner with dysglycaemia. Women with a partner with dysglycaemia had a significantly higher BMI, waist circumference and diastolic BP, and a significantly higher probability of low HDL-cholesterol (<1.29 mmol/l) and the metabolic syndrome compared with women with a normoglycaemic partner. No such differences were observed for men with or without a partner with dysglycaemia.
The high degree of spousal concordance found in this study suggests social clustering of glycaemic and cardiometabolic traits among biologically unrelated individuals. This provides us with an opportunity to target the behavioural interventions at the level of the ‘married couple’, which may be a novel and cost-effective method of combating the current diabetes epidemic.
KeywordsCardiometabolic traits Dysglycaemia Gestational diabetes mellitus India South Asian Spousal concordance Spouse Type 2 diabetes
Gestational diabetes mellitus
International Association of Diabetes and Pregnancy Study Groups
The authors are grateful to the study participants for generously donating their time and information. The authors would like to thank Y. Singh (Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, New Delhi, India) for technical assistance in conducting the study.
AG, YG and NT conceptualised the research, and were involved in study execution, data interpretation, manuscript preparation and revision. MK contributed to the study design, data interpretation and manuscript revision, and was responsible for the statistical analysis. NG supervised the laboratory work of this research and helped in the study design, data interpretation, manuscript preparation and revision. MJS, GK and NB contributed to the study execution, data interpretation, manuscript preparation and revision. All authors approved the final version of the manuscript. YG is the guarantor of this work.
This work was supported by a trainee grant from the Endocrine Society of India. The society and its members were not involved in any other aspect related to this manuscript.
Duality of interest
The authors declare that there is no duality of interest associated with this manuscript.
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