Hubert Department of Global Health, Emory University, USA.
Division of Research, Kaiser Permanente Northern California, USA.
Prev Med. 2017 Dec;105:52-57. doi: 10.1016/j.ypmed.2017.08.020. Epub 2017 Aug 18.
People socially connected with each other often share health risks, possibly due to shared environments and behaviors. In a cohort study, we examined whether incidence of diabetes was different for individuals with recently diagnosed partners compared to individuals similar on other characteristics but whose partners were never diagnosed with diabetes. We analyzed 2007-11 data from Kaiser Permanente Northern California (KPNC), an integrated health system with >3.5 million members. We estimated annual diabetes incidence controlling for demographic, socio-economic, behavioral, and health characteristics. Using propensity score matching and multivariate logistic regression, we compared odds of incident diabetes among co-residing partners ages 18-89years of people who had been diagnosed with diabetes during the previous year (in robustness checks up to the previous three years) and people who had never been diagnosed but were similar on observed characteristics. Partners of newly-diagnosed people had annual diabetes incidence of 16.4/1000, equivalent to10.8 times higher (95%CI: 9.2-12.6) than people whose spouses had never been diagnosed (1.5/1000). Odds remained higher three years after a spouses' diagnosis (45.4 vs. 11.7/1000). Adjusting for other characteristics, odds of diabetes for those with a partner diagnosed in the previous year were 8.7 times higher (CI: 7.4-10.2) than among those whose partner had never been diagnosed. Also, partners of persons with recently-diagnosed diabetes developed diabetes at much higher rates than the general KPNC and U.S.
Individuals with a recently diagnosed partner could be considered a high-risk population for screening and prevention.
社会关系密切的人通常会面临共同的健康风险,这可能是由于共同的环境和行为所致。在一项队列研究中,我们研究了与那些伴侣从未被诊断患有糖尿病的个体相比,最近被诊断为患有糖尿病的个体的糖尿病发病率是否存在差异。我们分析了 Kaiser Permanente Northern California(KPNC)2007-11 年的数据,这是一个拥有超过 350 万成员的综合性医疗系统。我们通过控制人口统计学、社会经济、行为和健康特征来估计糖尿病的年发病率。使用倾向评分匹配和多变量逻辑回归,我们比较了在过去一年中被诊断患有糖尿病的人和从未被诊断但在观察到的特征上相似的人的同居伴侣中,新诊断为糖尿病的人的糖尿病发病几率。新诊断为糖尿病的人的伴侣的年糖尿病发病率为 16.4/1000,相当于比配偶从未被诊断出糖尿病的人高 10.8 倍(95%CI:9.2-12.6)(1.5/1000)。在配偶诊断三年后,这种情况仍然更为严重(45.4 比 11.7/1000)。调整其他特征后,在过去一年中伴侣被诊断为糖尿病的人的糖尿病发病几率是配偶从未被诊断出糖尿病的人的 8.7 倍(CI:7.4-10.2)。此外,与一般的 KPNC 和美国人群相比,最近被诊断为糖尿病的人的伴侣的糖尿病发病率要高得多。
最近被诊断为糖尿病的伴侣的个体可能被视为筛查和预防的高风险人群。