Prevalence of impaired glucose tolerance and other types of dysglycaemia among young twins and singletons in Guinea-Bissau

Abstract

BackgroundTwins may be at increased risk of dysglycaemic disorders due to adverse fetal conditions. Data from Africa regarding this association is limited. We studied impaired glucose tolerance (IGT) and other types of dysglycemia among twins and singletons in Guinea-Bissau.MethodsThe study was conducted from February 2011 until March 2012 at the Bandim Health Project, a health and demographic surveillance system site in the capital Bissau. Twins (n = 209) and singletons (n = 182) were recruited from a previously established cohort. Oral glucose tolerance tests (OGTT) were performed, along with anthropometrics and collection of clinical and dietary data.ResultsMedian age was 16.6 and 14.2 years between twins and singletons, respectively (P = 0.08). Mean birth weight was 2410 vs. 3090 g, respectively (P < 0.001). Twins had higher median fasting- and two hour capillary plasma glucose, 5.4(3.2–8.2) vs. 5.0(3.2–11.5) mmol/L (P < 0.001) and 6.8(3.4–11.3) vs. 6.2(3.2–12.1) mmol/L (P < 0.001), respectively, compared to singletons. The prevalence of IGT was 2.5 % (5/209) vs. 3.5 % (6/182) (RR = 0.73, 95 % CI: 0.20–2.64). 12 % (25/209) of twins had impaired fasting glucose (IFG), compared to 3.5 % (6/182) of singletons (3.63, 1.53–8.62). Dysglycemia (IGT and/or IFG or overt diabetes) was found in 17 % (35/209) vs. 9 % (16/182) (1.90, 1.08–3.37), respectively.ConclusionsTwins had higher glucose levels in both the fasting and postprandial state. This may indicate a detrimental effect of the twin fetal environment on glucose metabolism later in life, a result contrary to Scandinavian register studies. The IGT burden was low in this young age group and the risk was similar in twins and singletons.Electronic supplementary materialThe online version of this article (doi:10.1186/s12902-016-0126-6) contains supplementary material, which is available to authorized users.

The Guinea-Bissau Twin Registry Update: A Platform for Studying Twin Mortality and Metabolic Disease

“…Despite twins in Guinea-Bissau having a much lower birth weight compared to singletons, we did not find higher rates of diabetes, MS and IGT among young twins in our studies (Bjerregaard-Andersen et al, 2013b;Hennild et al, 2016). This is in line with large-scale register studies from Scandinavia (Petersen et al, 2011).…”

“…In fact, based on glucose metabolism among extremely birth weight discordant MZ twin pairs, it has been proposed that there are common genetic factors in the relationship between low birth weight and adult metabolic disease (Frost et al, 2012). Interestingly, twins in our cohort did, however, have higher median glucose levels in both the fasting and in the post-prandial state, and also a higher body fat percentage (Hennild et al, 2016). As our cohort was young, we cannot exclude that our findings could be early indicators of an increased diabetes risk later in life.…”

“…For all twins, an age-matched singleton control from the BHP study area was enrolled. In a substudy, a group of twins and singleton controls underwent oral glucose tolerance testing (OGTT) (Hennild et al, 2016). Here, we also estimated body fat percentage using skinfold measurements.…”

“…A subset of the cohort (209 twins and 182 singleton controls) was investigated with OGTT from February 2011 to March 2012 (Hennild et al, 2016). Median age for those with an OGTT was 16.6 for twins and 14.2 years for singletons (p = .08).…”

Diabetes in urban Guinea-Bissau; patient characteristics, mortality and prevalence of undiagnosed dysglycemia

“…At the Health and Demographic Surveillance System (HDSS) site maintained by the Bandim Health Project (BHP) in Guinea-Bissau, we have previously assessed the prevalence of diabetes among specific groups such as HIV patients [9], tuberculosis patients [10] and twins [11,12]. The diabetes prevalence among adult controls in the tuberculosis study was 2.7%, while it was 5.8% among HIV patients.…”