单位：[1]Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.[2]Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.[3]Dalian Municipal Central Hospital, Dalian, China.大连市中心医院[4]Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.华中科技大学同济医学院附属协和医院[5]Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.[6]Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.华中科技大学同济医学院附属同济医院[7]Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.[8]Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.[9]Chinese People's Liberation Army General Hospital, Beijing, China.[10]The First Hospital of Lanzhou University, Lanzhou, China.[11]Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.中山大学附属第二医院[12]The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.[13]The Affiliated Hospital of Southwest Medical University, Luzhou, China.[14]The First Hospital of Jilin University, Changchun, China.[15]The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.[16]The First Affiliated Hospital of Guangxi Medical University, Nanning, China.[17]Qilu Hospital of Shandong University, Jinan, China.[18]Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China.[19]The Second Affiliated Hospital of Harbin Medical University, Harbin, China.[20]Central Hospital of Shanghai Jiading District, Shanghai, China.[21]Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China.江苏省人民医院[22]The First Affiliated Hospital of Anhui Medical University, Hefei, China.[23]Karamay Municipal People's Hospital, Xinjiang, China.[24]The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.江苏省人民医院[25]The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.重庆医科大学附属第一医院[26]Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.[27]Guiqian International General Hospital, Guiyang, China.
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.To explore the association of spousal diabetes status and cardiovascular health metrics with risk of incident diabetes in Chinese adults.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.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.Incident diabetes, diagnosed according to 2010 ADA criteria.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).In this study, spousal diabetes diagnosis with uncontrolled HbA1c level was associated with increased risk of incident diabetes, but strict management of spousal HbA1c level and improving ICVHM profiles may 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：
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 for Metabolic Disease.
第一作者单位：[1]Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.[2]Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
共同第一作者：
通讯作者：
通讯机构：[1]Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.[2]Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.[*1]Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
推荐引用方式(GB/T 7714)：
Zhao Zhiyun,Cao Qiuyu,Lu Jieli,et al.Association of Spousal Diabetes Status and Ideal Cardiovascular Health Metrics With Risk of Incident Diabetes Among Chinese Adults[J].JAMA NETWORK OPEN.2023,6(6):doi:10.1001/jamanetworkopen.2023.19038.
APA：
Zhao Zhiyun,Cao Qiuyu,Lu Jieli,Lin Hong,Gao Zhengnan...&Bi Yufang.(2023).Association of Spousal Diabetes Status and Ideal Cardiovascular Health Metrics With Risk of Incident Diabetes Among Chinese Adults.JAMA NETWORK OPEN,6,(6)
MLA：
Zhao Zhiyun,et al."Association of Spousal Diabetes Status and Ideal Cardiovascular Health Metrics With Risk of Incident Diabetes Among Chinese Adults".JAMA NETWORK OPEN 6..6(2023)
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