Risk of Metabolic Syndrome and Diabetes Among Young Twins and Singletons in Guinea-Bissau

Abstract

OBJECTIVETwins in Africa may be at increased risk of metabolic disorders due to strained conditions in utero, including high exposure to infections. We studied metabolic syndrome (MS) and diabetes mellitus (DM) among young twins and singletons in Guinea-Bissau.RESEARCH DESIGN AND METHODSThe study was cross-sectional and occurred from October 2009 until August 2011 at the Bandim Health Project, a demographic surveillance site in the capital Bissau. Twins and singleton controls between 5 and 32 years were visited at home. Fasting blood samples for metabolic measurements were collected. Zygosity was established genetically for a subset. DM was defined as HbA1c ≥6.5% (48 mmol/mol) and MS by the International Diabetes Federation criteria.RESULTSHbA1c was available for 574 twins and 463 singletons. Mean age was 15.3 years versus 15.8 years, respectively. Eighteen percent of twins were monozygotic. There were no DM cases among twins but one among singletons. A total of 1.4% (8 of 574) of twins had elevated HbA1c (6.0–6.4%, 42–46 mmol/mol) compared with 2.4% (11 of 463) of singletons (P = 0.28). Mean HbA1c was 5.3% (34 mmol/mol) for both groups. MS data were available for 364 twins and 360 singletons. The MS prevalence was 3.0% (11 of 364) among twins and 3.6% (13 of 360) among singletons (P = 0.66). The prevalence of fasting blood glucose (F-glucose) ≥5.6 mmol/L was 34.9% (127 of 364) for twins versus 24.7% (89 of 360) for singletons (P = 0.003). Median homeostasis model assessment–insulin resistance did not differ (P = 0.34).CONCLUSIONSThe MS and DM prevalences among young individuals in Guinea-Bissau were low. Twins did not have a higher MS and DM burden than singletons, though elevated F-glucose was more common among twins.

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

“…No difference was found in mean HbA1c either. Yet, as in the present investigation, higher fasting glucose and higher IFG prevalence were found in twins [ 26 ]. Adjusting for potential confounders such as age, sex, WHR and season caused the association between twin status and IFG to become even stronger.…”

“…We did not have data regarding insulin sensitivity or beta cell function during the OGTTs. In the previous study, no difference was found in fasting insulin or HOMA insulin resistance between twins and singletons [ 26 ].…”

“…Our study took place from February 2011 until March 2012, including during the rainy season from May to October. Participants were recruited from a large cohort, designed to investigate the prevalence of DM and metabolic syndrome among young twins and singletons [ 26 ]. Twins in the present sub-study were drawn by opportunity from the original cohort, i.e., a field assistant and a laboratory technician would re-visit the houses in the BHP study area in a random order, enrolling any of the previously participating twins available.…”

“…Using data from the previous study, genetically established zygosity was available for a subset of twins. Zygosity had also previously been evaluated by physical similarity in twin pairs, with 89 % correctness [ 26 ].…”

Metabolic Syndrome Among Children and Adolescents in Low and Middle Income Countries: A Systematic Review and Meta-analysis

“…Seventy six articles were included in the nal analysis in this meta-analysis. Twenty ve studies were excluded due to the following exclusion criteria: different study population [109][110][111][112][113], no full test [114][115][116][117], unclear diagnostic criteria [118][119][120][121][122][123][124][125], letter to editor [126], written in non English language [127,128], and different study design [129][130][131][132][133] (Fig. 1).…”