Association of Spousal Diabetes Status and Ideal Cardiovascular Health Metrics With Risk of Incident Diabetes Among Chinese Adults

作者全名："Zhao, Zhiyun; Cao, Qiuyu; Lu, Jieli; Lin, Hong; Gao, Zhengnan; Xu, Min; Xu, Yu; Wang, Tiange; Li, Mian; Chen, Yuhong; Wang, Shuangyuan; Zeng, Tianshu; Hu, Ruying; Yu, Xuefeng; Chen, Gang; Su, Qing; Mu, Yiming; Chen, Lulu; Tang, Xulei; Yan, Li; Qin, Guijun; Wan, Qin; Wang, Guixia; Shen, Feixia; Luo, Zuojie; Qin, Yingfen; Chen, Li; Huo, Yanan; Li, Qiang; Ye, Zhen; Zhang, Yinfei; Liu, Chao; Wang, Youmin; Wu, Shengli; Yang, Tao; Deng, Huacong; Zhao, Jiajun; Shi, Lixin; Ning, Guang; Wang, Weiqing; Bi, Yufang"

作者地址："[Zhao, Zhiyun; Cao, Qiuyu; Lu, Jieli; Lin, Hong; Xu, Min; Xu, Yu; Wang, Tiange; Li, Mian; Chen, Yuhong; Wang, Shuangyuan; Ning, Guang; Wang, Weiqing; Bi, Yufang] Shanghai Jiao Tong Univ, Dept Endocrine & Metab Dis, Shanghai Inst Endocrine & Metab Dis, Ruijin Hosp,Sch Med, 197 Rui Jin 2nd Rd, Shanghai 200025, Peoples R China; [Zhao, Zhiyun; Cao, Qiuyu; Lu, Jieli; Lin, Hong; Xu, Min; Xu, Yu; Wang, Tiange; Li, Mian; Chen, Yuhong; Wang, Shuangyuan; Ning, Guang; Wang, Weiqing; Bi, Yufang] Shanghai Jiao Tong Univ, Shanghai Natl Clin Res Ctr Metabol Dis, Key Lab Endocrine & Metab Dis Natl Hlth Commiss P, Shanghai Key Lab Endocrine Tumor,Ruijin Hosp,Sch, Shanghai, Peoples R China; [Gao, Zhengnan] Dalian Municipal Cent Hosp, Dalian, Peoples R China; [Zeng, Tianshu; Chen, Lulu] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Wuhan, Peoples R China; [Hu, Ruying; Ye, Zhen] Zhejiang Prov Ctr Dis Control & Prevent, Hangzhou, Peoples R China; [Yu, Xuefeng] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China; [Chen, Gang] Fujian Med Univ, Fujian Prov Hosp, Fuzhou, Peoples R China; [Su, Qing] Shanghai Jiao Tong Univ, Sch Med, Xinhua Hosp, Shanghai, Peoples R China; [Mu, Yiming] Chinese Peoples Liberat Army Gen Hosp, Beijing, Peoples R China; [Tang, Xulei] Lanzhou Univ, Hosp 1, Lanzhou, Peoples R China; [Yan, Li] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Peoples R China; [Qin, Guijun] Zhengzhou Univ, Affiliated Hosp 1, Zhengzhou, Peoples R China; [Wan, Qin] Southwest Med Univ, Affiliated Hosp, Luzhou, Peoples R China; [Wang, Guixia] First Hosp Jilin Univ, Changchun, Peoples R China; [Shen, Feixia] Wenzhou Med Univ, Affiliated Hosp 1, Wenzhou, Peoples R China; [Luo, Zuojie; Qin, Yingfen] Guangxi Med Univ, Affiliated Hosp 1, Nanning, Peoples R China; [Chen, Li] Shandong Univ, Qilu Hosp, Jinan, Peoples R China; [Huo, Yanan] Nanchang Univ, Jiangxi Prov Peoples Hosp, Nanchang, Jiangxi, Peoples R China; [Li, Qiang] Harbin Med Univ, Affiliated Hosp 2, Harbin, Peoples R China; [Zhang, Yinfei] Cent Hosp Shanghai Jiading Dist, Shanghai, Peoples R China; [Liu, Chao] Jiangsu Prov Hosp Integrat Chinese & Western Med, Nanjing, Peoples R China; [Wang, Youmin] Anhui Med Univ, Affiliated Hosp 1, Hefei, Peoples R China; [Wu, Shengli] Karamay Municipal Peoples Hosp, Xinjiang, Peoples R China; [Yang, Tao] Nanjing Med Univ, Affiliated Hosp 1, Nanjing, Peoples R China; [Deng, Huacong] Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China; [Zhao, Jiajun] Shandong Univ, Shandong Prov Hosp, Jinan, Peoples R China; [Shi, Lixin] Guiqian Int Gen Hosp, Guiyang, Peoples R China"

通信作者："Wang, WQ; Bi, YF (通讯作者)，Shanghai Jiao Tong Univ, Dept Endocrine & Metab Dis, Shanghai Inst Endocrine & Metab Dis, Ruijin Hosp,Sch Med, 197 Rui Jin 2nd Rd, Shanghai 200025, Peoples R China."

来源：JAMA NETWORK OPEN

ESI学科分类：　

WOS号：WOS:001059378300002

JCR分区：Q1

影响因子：10.5

年份：2023

卷号：6

期号：6

开始页：　

结束页：　

文献类型：Article

关键词：　

摘要："IMPORTANCE Spouses share common socioeconomic, environmental, and lifestyle factors, and multiple studies have found that spousal diabetes status was associated with diabetes prevalence. But the association of spousal diabetes status and ideal cardiovascular health metrics (ICVHMs) assessed by the American Heart Association's Life's Essential 8 measures with incident diabetes has not been comprehensively characterized, especially in large-scale cohort studies. OBJECTIVE To explore the association of spousal diabetes status and cardiovascular health metrics with risk of incident diabetes in Chinese adults. DESIGN, SETTING, AND PARTICIPANTS This cohort study included individuals in the China Cardiovascular Disease and Cancer Cohort without diabetes who underwent baseline and follow-up glucose measurements and had spouses with baseline glucose measurements. The data were collected in January 2011 to December 2012 and March 2014 to December 2016. The spousal study had a mean (SD) follow-up of 3.6 (0.9) years (median [IQR], 3.2 [2.9-4.5] years). Statistical analysis was performed from July to November 2022. EXPOSURE Spousal diabetes status was diagnosed according to the 2010 American Diabetes Association (ADA) criteria. All participants provided detailed clinical, sociodemographic, and lifestyle information included in cardiovascular health metrics. MAIN OUTCOMES AND MEASURES Incident diabetes, diagnosed according to 2010 ADA criteria. RESULTS Overall, 34 821 individuals were included, with a mean (SD) age of 56.4 (8.3) years and 16 699 (48.0%) male participants. Spousal diabetes diagnosis was associated with an increased risk of incident diabetes (hazard ratio [HR], 1.15; 95% CI, 1.03-1.30). Furthermore, participants whose spouses had uncontrolled glycated hemoglobin (HbA1c) had a higher risk of diabetes (HR, 1.20; 95% CI, 1.04-1.39) but the risk of diabetes in participants whose spouses had controlled HbA1c did not increase significantly (HR, 1.10; 95% CI, 0.92-1.30). Moreover, this association varied with composite cardiovascular health status. Diabetes risk in individuals who had poor cardiovascular health status (<4 ICVHMs) was associated with spousal diabetes status (3 ICVHMs: HR, 1.50; 95% CI, 1.15-1.97), while diabetes risk in individuals who had intermediate to ideal cardiovascular health status ( >= 4 ICVHMs) was not associated with it (4 ICVHMs: HR, 1.01; 95% CI, 0.69-1.50). CONCLUSIONS AND RELEVANCE In this study, spousal diabetes diagnosis with uncontrolled HbA(1c) levelwas associated with increased risk of incident diabetes, but strict management of spousal HbA(1c) level and improving ICVHM profilesmay attenuate the association of spousal diabetes status with diabetes risk. These findings suggest the potential benefit of couple-based lifestyle or pharmaceutical interventions for diabetes."

基金机构："National Natural Science Foundation of China [82070880, 81500660, 82200998, 81970728, 82022011, 81941017, 81970706, 81870560]; Shanghai Municipal Government [18411951800]; Shanghai Shen Kang Hospital Development Center [SHDC12019101, SHDC2020CR1001A, SHDC2020CR3064B]; Program for Professor of Special Appointment (Younger Eastern Scholar) at Shanghai Institutions of Higher Learning [QD2016007]; Innovative Research Team of High-level Local Universities in Shanghai; Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support [20161307, 20152508]; Shanghai Clinical Research Center forMetabolic Disease [19MC1910100]"

基金资助正文："This work was supported by the grants 82070880, 81500660, 82200998, 81970728, 82022011, 81941017, 81970706, and 81870560 from the National Natural Science Foundation of China; grant 18411951800 from the Shanghai Municipal Government; grants SHDC12019101, SHDC2020CR1001A, and SHDC2020CR3064B from the Shanghai Shen Kang Hospital Development Center; award QD2016007 from the Program for Professor of Special Appointment (Younger Eastern Scholar) at Shanghai Institutions of Higher Learning; Innovative Research Team of High-level Local Universities in Shanghai; grants 20161307 and 20152508 Round 2 from the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support; and grant 19MC1910100 from the Shanghai Clinical Research Center forMetabolic Disease."