Couple concordance in diabetes, hypertension and dyslipidaemia in urban India and Pakistan and associated socioeconomic and household characteristics and modifiable risk factors.
Couple concordance in diabetes, hypertension and dyslipidaemia in urban India and Pakistan and associated socioeconomic and household characteristics and modifiable risk factors.
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印度和巴基斯坦城市地区夫妇糖尿病、高血压和血脂异常的一致性以及相关的社会经济和家庭特征以及可改变的危险因素。
DOI：
10.1136/jech-2022-219979
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发表时间：
2023
影响因子：
6.3
通讯作者：
Patel,ShivaniAnil
中科院分区：
文献类型：
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作者：
Nielsen,Jannie;Shivashankar,Roopa;Cunningham,SolveigA;Prabhakaran,Dorairaj;Tandon,Nikhil;Mohan,Viswanathan;Iqbal,Romaina;Narayan,KmVenkat;Ali,MohammedK;Patel,ShivaniAnil
研究背景夫妇间慢性病状态的一致性已被观察到。在印度和巴基斯坦的城市，很少有人知道夫妇一致性糖尿病，高血压，血脂异常和相关的社会经济特征和可修改的风险factors.MethodsWe分析了从2548对夫妇的cArdio-metabolic风险降低中心在南亚队列在钦奈，德里和卡拉奇的横截面数据。我们估计了存在≥1种糖尿病、高血压和血脂异常的夫妇一致性（阳性一致性：配偶双方（W+H+）;阴性一致性：配偶双方都没有（W−H−）;不一致的妻子：只有妻子（W+H−）;或不一致的丈夫：只有丈夫（W−H+））。我们评估了五个社会经济和家庭特征的关联，以及六个可改变的风险因素与夫妇一致性，使用多项逻辑回归模型，以夫妇为分析单位（参考文献：W−H−）。（95% CI 57.4%至61.3%）在慢性疾病中一致（W+H+：29.2%（95% CI 27.4%至31.0%）; W-H-：30.2%）（95% CI 28.4%-32.0%））;和40.6%（95% CI 38.7%-42.6%）不一致（W+H−：13.1%（95% CI 11.8%-14.4%）; W−H+：27.6%（95% CI 25.9%-29.4%））。与没有条件的夫妇（W-H-）相比，如果夫妇的收入水平较高或较低，那么他们至少有一种条件的相对几率更高：（OR 2.03（95% CI 1.47 - 2.80）），财富（OR 2.66（95% CI 1.98 - 3.58））和教育（妻子的教育程度：OR 1.92（95%CI 1.29 - 2.86）;丈夫的教育程度：或2.98（95% CI 1.92 - 4.66））或体重状态（配偶双方超重或肥胖的OR值为7.17（95%CI为4.99 - 10.30））。结论在印度和巴基斯坦的城市地区，特别是在社会经济地位相对较高的夫妇中。这表明，预防和管理的重点是夫妇在高风险的一致的慢性疾病可能是有效的，更是如此，在较高的社会经济群体。
BackgroundConcordance in chronic disease status has been observed within couples. In urban India and Pakistan, little is known about couple concordance in diabetes, hypertension, and dyslipidaemia and associated socioeconomic characteristics and modifiable risk factors.MethodsWe analysed cross-sectional data from 2548 couples from the Centre for cArdio-metabolic Risk Reduction in South Asia cohort in Chennai, Delhi and Karachi. We estimated couple concordance in presence of ≥1 of diabetes, hypertension and dyslipidaemia (positive concordance: both spouses (W+H+); negative concordance: neither spouse (W−H−); discordant wife: only wife (W+H−); or discordant husband: only husband (W−H+)). We assessed associations of five socioeconomic and household characteristics, and six modifiable risk factors with couple concordance using multinomial logistic regression models with couples as the unit of analysis (reference: W−H−).ResultsOf the couples, 59.4% (95% CI 57.4% to 61.3%) were concordant in chronic conditions (W+H+: 29.2% (95% CI 27.4% to 31.0%); W−H−: 30.2% (95% CI 28.4%− to 32.0%)); and 40.6% (95% CI 38.7% to 42.6%) discordant (W+H−: 13.1% (95% CI 11.8% to 14.4%); W−H+: 27.6% (95% CI 25.9% to 29.4%)). Compared with couples with no conditions (W−H−), couples had higher relative odds of both having at least one condition if they had higher versus lower levels of: income (OR 2.03 (95% CI 1.47 to 2.80)), wealth (OR 2.66 (95% CI 1.98 to 3.58)) and education (wives’ education: OR 1.92 (95% CI 1.29 to 2.86); husbands’ education: OR 2.98 (95% CI 1.92 to 4.66)) or weight status (overweight or obesity in both spouses ORs 7.17 (95% CI 4.99 to 10.30)).ConclusionsPositive couple concordance in major chronic conditions is high in urban India and Pakistan, especially among couples with relatively higher socioeconomic position. This suggests that prevention and management focusing on couples at high risk for concordant chronic conditions may be effective and more so in higher socioeconomic groups.