@article{d6e0f93c02e44f1f862ab3260dfc671c,
title = "Spousal concordance in pathophysiological markers and risk factors for type 2 diabetes: a cross-sectional analysis of The Maastricht Study",
abstract = "Introduction We compared the degree of spousal concordance in a set of detailed pathophysiological markers and risk factors for type 2 diabetes to understand where in the causal cascade spousal similarities are most relevant.Research design and methods This is a cross-sectional analysis of couples who participated in The Maastricht Study (n=172). We used quantile regression models to assess spousal concordance in risk factors for type 2 diabetes, including four adiposity measures, two dimensions of physical activity, sedentary time and two diet indicators. We additionally assessed beta cell function and insulin sensitivity and glucose metabolism status with fasting and 2-hour plasma glucose and hemoglobin A1c.Results The strongest spousal concordance (beta estimates) was observed for the Dutch Healthy Diet Index (DHDI) in men. A one-unit increase in wives' DHDI was associated with a 0.53 (95% CI 0.22 to 0.67) unit difference in men's DHDI. In women, the strongest concordance was for the time spent in high-intensity physical activity (HPA); thus, a one-unit increase in husbands' time spent in HPA was associated with a 0.36 (95% CI 0.17 to 0.64) unit difference in women's time spent in HPA. The weakest spousal concordance was observed in beta cell function indices.Conclusions Spousal concordance was strongest in behavioral risk factors. Concordance weakened when moving downstream in the causal cascade leading to type 2 diabetes. Public health prevention strategies to mitigate diabetes risk may benefit from targeting spousal similarities in health-related behaviors and diabetes risk factors to design innovative and potentially more effective couple-based interventions.",
keywords = "diabetes mellitus, epidemiology, insulin resistance, risk factors, type 2, BEHAVIOR, MARRIED-COUPLES, SOCIAL NETWORK, OBESITY, PHYSICAL-ACTIVITY, HEALTH, INDEX, QUESTIONNAIRE",
author = "O. Silverman-Retana and S. Brinkhues and A. Hulman and C.D.A. Stehouwer and N.H.T.M. Dukers-Muijrers and R.K. Simmons and H. Bosma and S. Eussen and A. Koster and P. Dagnelie and H.H.C.M. Savelberg and N.C. Schaper and {van Dongen}, M.C.J.M. and D.R. Witte and M.T. Schram",
note = "Funding Information: 1Department of Public Health, Aarhus University, Aarhus, Denmark 2Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark 3Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands 4Department of Knowledge and Innovation, Public Health Service South Limburg, Heerlen, The Netherlands 5Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands 6Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands 7Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands 8Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands 9Department of Social Medicine, Maastricht University, Maastricht, The Netherlands 10Department of Epidemiology, Maastricht University, Maastricht, The Netherlands 11Department of Nutrition and Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands Acknowledgements This work was the result of OS-R{\textquoteright}s research stay abroad at The Maastricht Study Research Center, Maastricht University Medical Center+, Maastricht, The Netherlands, under supervision of MTS. This research stay abroad was supported by the European Foundation for the Study of Diabetes (EFSD) Albert Renold Travel Fellowship Programme; the Danish Diabetes Association (Diabetesforeningen); and the Graduate School of Health, Aarhus University, Aarhus, Denmark. Funding Information: Funding The Maastricht Study was supported by the European Regional Development Fund via OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs (grant 31O.041), Stichting De Weijerhorst (Maastricht, The Netherlands), the Pearl String Initiative Diabetes (Amsterdam, The Netherlands), the Cardiovascular Center (CVC, Maastricht, the Netherlands), CARIM School for Cardiovascular Diseases (Maastricht, The Netherlands), CAPHRI Care and Public Health Research Institute (Maastricht, The Netherlands), NUTRIM School for Nutrition and Translational Research in Metabolism (Maastricht, the Netherlands), Stichting Annadal (Maastricht, The Netherlands), Health Foundation Limburg (Maastricht, The Netherlands), and by unrestricted grants from Janssen-Cilag (Tilburg, The Netherlands), Novo Nordisk Farma (Alphen aan den Rijn, The Netherlands), and Sanofi-Aventis Netherlands (Gouda, The Netherlands). MTS is the guarantor of this work. OS-R is funded by the Danish Diabetes Academy, which is in turn funded by the Novo Nordisk Foundation. OS-R, AH and DRW received support provided by the Steno Diabetes Center Aarhus (SDCA), which is partially funded by an unrestricted donation from the Novo Nordisk Foundation. OS-R received travel grant support from the EFSD Albert Renold Travel Fellowship Programme; the Danish Diabetes Association (Diabetesforeningen); and the Graduate School of Health, Aarhus University, Denmark, to carry out a 10-week research stay abroad at the Maastricht Study Research Center, Maastricht University Medical Center+, Maastricht, The Netherlands. Publisher Copyright: {\textcopyright}",
year = "2021",
month = jan,
day = "1",
doi = "10.1136/bmjdrc-2020-001879",
language = "English",
volume = "9",
journal = "BMJ Open Diabetes Research & Care",
issn = "2052-4897",
publisher = "BMJ Publishing Group",
number = "1",
}