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Household and familial resemblance in risk factors for type 2 diabetes and related cardiometabolic diseases in rural Uganda: a cross-sectional community sample.

Household and familial resemblance in risk factors for type 2 diabetes and related cardiometabolic diseases in rural Uganda: a cross-sectional community sample.
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Nielsen J, Bahendeka SK, Whyte SR, Meyrowitsch DW, Bygbjerg IC, Witte DR,


Nielsen J, Bahendeka SK, Whyte SR, Meyrowitsch DW, Bygbjerg IC, Witte DR, (click to view)

Nielsen J, Bahendeka SK, Whyte SR, Meyrowitsch DW, Bygbjerg IC, Witte DR,

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BMJ open 2017 09 217(9) e015214 doi 10.1136/bmjopen-2016-015214
Abstract
OBJECTIVES
Prevention of type 2 diabetes (T2D) has been successfully established in randomised clinical trials. However, the best methods for the translation of this evidence into effective population-wide interventions remain unclear. To assess whether households could be a target for T2D prevention and screening, we investigated the resemblance of T2D risk factors at household level and by type of familial dyadic relationship in a rural Ugandan community.

METHODS
This cross-sectional household-based study included 437 individuals ≥13 years of age from 90 rural households in south-western Uganda. Resemblance in glycosylated haemoglobin (HbA1c), anthropometry, blood pressure, fitness status and sitting time were analysed using a general mixed model with random effects (by household or dyad) to calculate household intraclass correlation coefficients (ICCs) and dyadic regression coefficients. Logistic regression with household as a random effect was used to calculate the ORs for individuals having a condition or risk factor if another household member had the same condition.

RESULTS
The strongest degree of household member resemblances in T2D risk factors was seen in relation to fitness status (ICC=0.24), HbA1c (ICC=0.18) and systolic blood pressure (ICC=0.11). Regarding dyadic resemblance, the highest standardised regression coefficient was seen in fitness status for spouses (0.54, 95% CI 0.32 to 0.76), parent-offspring (0.41, 95% CI 0.28 0.54) and siblings (0.41, 95% CI 0.25 to 0.57). Overall, parent-offspring and sibling pairs were the dyads with strongest resemblance, followed by spouses.

CONCLUSIONS
The marked degree of resemblance in T2D risk factors at household level and between spouses, parent-offspring and sibling dyads suggest that shared behavioural and environmental factors may influence risk factor levels among cohabiting individuals, which point to the potential of the household setting for screening and prevention of T2D.

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