Household and familial resemblance in risk factors for type 2 diabetes and related cardiometabolic diseases in rural Uganda: a cross-sectional community sample
Identifieur interne : 004688 ( Ncbi/Merge ); précédent : 004687; suivant : 004689Household and familial resemblance in risk factors for type 2 diabetes and related cardiometabolic diseases in rural Uganda: a cross-sectional community sample
Auteurs : Jannie Nielsen [Danemark] ; Silver K. Bahendeka [Ouganda] ; Susan R. Whyte [Danemark] ; Dan W. Meyrowitsch [Danemark] ; Ib C. Bygbjerg [Danemark] ; Daniel R. Witte [Danemark]Source :
- BMJ Open [ 2044-6055 ] ; 2017.
Abstract
Prevention of type 2 diabetes (T2D) has been successfully established in randomised clinical trials. However, the best methods for the translation of this evidence into effective population-wide interventions remain unclear. To assess whether households could be a target for T2D prevention and screening, we investigated the resemblance of T2D risk factors at household level and by type of familial dyadic relationship in a rural Ugandan community.
This cross-sectional household-based study included 437 individuals ≥13 years of age from 90 rural households in south-western Uganda. Resemblance in glycosylated haemoglobin (HbA1c), anthropometry, blood pressure, fitness status and sitting time were analysed using a general mixed model with random effects (by household or dyad) to calculate household intraclass correlation coefficients (ICCs) and dyadic regression coefficients. Logistic regression with household as a random effect was used to calculate the ORs for individuals having a condition or risk factor if another household member had the same condition.
The strongest degree of household member resemblances in T2D risk factors was seen in relation to fitness status (ICC=0.24), HbA1c (ICC=0.18) and systolic blood pressure (ICC=0.11). Regarding dyadic resemblance, the highest standardised regression coefficient was seen in fitness status for spouses (0.54, 95% CI 0.32 to 0.76), parent–offspring (0.41, 95% CI 0.28 0.54) and siblings (0.41, 95% CI 0.25 to 0.57). Overall, parent–offspring and sibling pairs were the dyads with strongest resemblance, followed by spouses.
The marked degree of resemblance in T2D risk factors at household level and between spouses, parent–offspring and sibling dyads suggest that shared behavioural and environmental factors may influence risk factor levels among cohabiting individuals, which point to the potential of the household setting for screening and prevention of T2D.
Url:
DOI: 10.1136/bmjopen-2016-015214
PubMed: 28939566
PubMed Central: 5623496
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<front><div type="abstract" xml:lang="en"><sec><title>Objectives</title>
<p>Prevention of type 2 diabetes (T2D) has been successfully established in randomised clinical trials. However, the best methods for the translation of this evidence into effective population-wide interventions remain unclear. To assess whether households could be a target for T2D prevention and screening, we investigated the resemblance of T2D risk factors at household level and by type of familial dyadic relationship in a rural Ugandan community.</p>
</sec>
<sec><title>Methods</title>
<p>This cross-sectional household-based study included 437 individuals ≥13 years of age from 90 rural households in south-western Uganda. Resemblance in glycosylated haemoglobin (HbA1c), anthropometry, blood pressure, fitness status and sitting time were analysed using a general mixed model with random effects (by household or dyad) to calculate household intraclass correlation coefficients (ICCs) and dyadic regression coefficients. Logistic regression with household as a random effect was used to calculate the ORs for individuals having a condition or risk factor if another household member had the same condition.</p>
</sec>
<sec><title>Results</title>
<p>The strongest degree of household member resemblances in T2D risk factors was seen in relation to fitness status (ICC=0.24), HbA1c (ICC=0.18) and systolic blood pressure (ICC=0.11). Regarding dyadic resemblance, the highest standardised regression coefficient was seen in fitness status for spouses (0.54, 95% CI 0.32 to 0.76), parent–offspring (0.41, 95% CI 0.28 0.54) and siblings (0.41, 95% CI 0.25 to 0.57). Overall, parent–offspring and sibling pairs were the dyads with strongest resemblance, followed by spouses.</p>
</sec>
<sec><title>Conclusions</title>
<p>The marked degree of resemblance in T2D risk factors at household level and between spouses, parent–offspring and sibling dyads suggest that shared behavioural and environmental factors may influence risk factor levels among cohabiting individuals, which point to the potential of the household setting for screening and prevention of T2D.</p>
</sec>
</div>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ Open</journal-id>
<journal-id journal-id-type="iso-abbrev">BMJ Open</journal-id>
<journal-id journal-id-type="hwp">bmjopen</journal-id>
<journal-id journal-id-type="publisher-id">bmjopen</journal-id>
<journal-title-group><journal-title>BMJ Open</journal-title>
</journal-title-group>
<issn pub-type="epub">2044-6055</issn>
<publisher><publisher-name>BMJ Publishing Group</publisher-name>
<publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">28939566</article-id>
<article-id pub-id-type="pmc">5623496</article-id>
<article-id pub-id-type="publisher-id">bmjopen-2016-015214</article-id>
<article-id pub-id-type="doi">10.1136/bmjopen-2016-015214</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Public Health</subject>
<subj-group><subject>Research</subject>
</subj-group>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject>
<subject>1724</subject>
<subject>1359</subject>
<subject>655</subject>
</subj-group>
</article-categories>
<title-group><article-title>Household and familial resemblance in risk factors for type 2 diabetes and related cardiometabolic diseases in rural Uganda: a cross-sectional community sample</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Nielsen</surname>
<given-names>Jannie</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bahendeka</surname>
<given-names>Silver K</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Whyte</surname>
<given-names>Susan R</given-names>
</name>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Meyrowitsch</surname>
<given-names>Dan W</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bygbjerg</surname>
<given-names>Ib C</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Witte</surname>
<given-names>Daniel R</given-names>
</name>
<xref ref-type="aff" rid="aff4">4</xref>
<xref ref-type="aff" rid="aff5">5</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<institution content-type="department">Department of Public Health, Global Health Section</institution>
,<institution>University of Copenhagen</institution>
,<addr-line content-type="city">Copenhagen</addr-line>
,<country>Denmark</country>
</aff>
<aff id="aff2"><label>2</label>
<institution>St Francis Hospital Nsambya</institution>
,<addr-line content-type="city">Kampala</addr-line>
,<country>Uganda</country>
</aff>
<aff id="aff3"><label>3</label>
<institution content-type="department">Department of Anthropology</institution>
,<institution>University of Copenhagen</institution>
,<addr-line content-type="city">Copenhagen</addr-line>
,<country>Denmark</country>
</aff>
<aff id="aff5"><label>5</label>
<institution content-type="department">Department of Public Health</institution>
,<institution>University of Aarhus</institution>
,<addr-line content-type="city">Aarhus</addr-line>
,<country>Denmark</country>
</aff>
<aff id="aff4"><label>4</label>
<institution>Danish Diabetes Academy</institution>
,<addr-line content-type="city">Odense</addr-line>
,<country>Denmark</country>
</aff>
<author-notes><corresp><label>Correspondence to</label>
Dr Jannie Nielsen; <email>jannien@sund.ku.dk</email>
</corresp>
</author-notes>
<pub-date pub-type="collection"><year>2017</year>
</pub-date>
<pub-date pub-type="epub"><day>21</day>
<month>9</month>
<year>2017</year>
</pub-date>
<volume>7</volume>
<issue>9</issue>
<elocation-id>e015214</elocation-id>
<history><date date-type="received"><day>21</day>
<month>11</month>
<year>2016</year>
</date>
<date date-type="rev-recd"><day>21</day>
<month>7</month>
<year>2017</year>
</date>
<date date-type="accepted"><day>26</day>
<month>7</month>
<year>2017</year>
</date>
</history>
<permissions><copyright-statement>© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</copyright-statement>
<copyright-year>2017</copyright-year>
<license license-type="open-access"><license-p>This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>
</license-p>
</license>
</permissions>
<self-uri xlink:title="pdf" xlink:href="bmjopen-2016-015214.pdf"></self-uri>
<self-uri content-type="reviewers-comments-pdf" xlink:href="bmjopen-2016-015214.reviewer_comments.pdf"></self-uri>
<self-uri content-type="draft-revisions-pdf" xlink:href="bmjopen-2016-015214.draft_revisions.pdf"></self-uri>
<abstract><sec><title>Objectives</title>
<p>Prevention of type 2 diabetes (T2D) has been successfully established in randomised clinical trials. However, the best methods for the translation of this evidence into effective population-wide interventions remain unclear. To assess whether households could be a target for T2D prevention and screening, we investigated the resemblance of T2D risk factors at household level and by type of familial dyadic relationship in a rural Ugandan community.</p>
</sec>
<sec><title>Methods</title>
<p>This cross-sectional household-based study included 437 individuals ≥13 years of age from 90 rural households in south-western Uganda. Resemblance in glycosylated haemoglobin (HbA1c), anthropometry, blood pressure, fitness status and sitting time were analysed using a general mixed model with random effects (by household or dyad) to calculate household intraclass correlation coefficients (ICCs) and dyadic regression coefficients. Logistic regression with household as a random effect was used to calculate the ORs for individuals having a condition or risk factor if another household member had the same condition.</p>
</sec>
<sec><title>Results</title>
<p>The strongest degree of household member resemblances in T2D risk factors was seen in relation to fitness status (ICC=0.24), HbA1c (ICC=0.18) and systolic blood pressure (ICC=0.11). Regarding dyadic resemblance, the highest standardised regression coefficient was seen in fitness status for spouses (0.54, 95% CI 0.32 to 0.76), parent–offspring (0.41, 95% CI 0.28 0.54) and siblings (0.41, 95% CI 0.25 to 0.57). Overall, parent–offspring and sibling pairs were the dyads with strongest resemblance, followed by spouses.</p>
</sec>
<sec><title>Conclusions</title>
<p>The marked degree of resemblance in T2D risk factors at household level and between spouses, parent–offspring and sibling dyads suggest that shared behavioural and environmental factors may influence risk factor levels among cohabiting individuals, which point to the potential of the household setting for screening and prevention of T2D.</p>
</sec>
</abstract>
<kwd-group><kwd>Public Health</kwd>
<kwd>General Diabetes</kwd>
<kwd>Epidemiology</kwd>
</kwd-group>
<funding-group><award-group id="funding-1"><funding-source><institution-wrap><institution>Thorvald Madsens Fond</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-2"><funding-source><institution-wrap><institution>Christian and Otilia Brorsons Rejselegat</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-3"><funding-source><institution-wrap><institution>Novo Nordisk Foundation</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-4"><funding-source><institution-wrap><institution>Aase and Ejnar Danielsens Fond</institution>
</institution-wrap>
</funding-source>
</award-group>
</funding-group>
<custom-meta-group><custom-meta><meta-name>special-feature</meta-name>
<meta-value>unlocked</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Danemark</li>
<li>Ouganda</li>
</country>
</list>
<tree><country name="Danemark"><noRegion><name sortKey="Nielsen, Jannie" sort="Nielsen, Jannie" uniqKey="Nielsen J" first="Jannie" last="Nielsen">Jannie Nielsen</name>
</noRegion>
<name sortKey="Bygbjerg, Ib C" sort="Bygbjerg, Ib C" uniqKey="Bygbjerg I" first="Ib C" last="Bygbjerg">Ib C. Bygbjerg</name>
<name sortKey="Meyrowitsch, Dan W" sort="Meyrowitsch, Dan W" uniqKey="Meyrowitsch D" first="Dan W" last="Meyrowitsch">Dan W. Meyrowitsch</name>
<name sortKey="Whyte, Susan R" sort="Whyte, Susan R" uniqKey="Whyte S" first="Susan R" last="Whyte">Susan R. Whyte</name>
<name sortKey="Witte, Daniel R" sort="Witte, Daniel R" uniqKey="Witte D" first="Daniel R" last="Witte">Daniel R. Witte</name>
<name sortKey="Witte, Daniel R" sort="Witte, Daniel R" uniqKey="Witte D" first="Daniel R" last="Witte">Daniel R. Witte</name>
</country>
<country name="Ouganda"><noRegion><name sortKey="Bahendeka, Silver K" sort="Bahendeka, Silver K" uniqKey="Bahendeka S" first="Silver K" last="Bahendeka">Silver K. Bahendeka</name>
</noRegion>
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</affiliations>
</record>
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