Investigating spousal concordance of diabetes through statistical analysis and data mining

Jong-Yi Wang; Chiu-Shong Liu; Chi-Hsuan Lung; Ya-Tun Yang; Ming-Hung Lin

doi:10.1371/journal.pone.0183413

Investigating spousal concordance of diabetes through statistical analysis and data mining

PLoS One. 2017 Aug 17;12(8):e0183413. doi: 10.1371/journal.pone.0183413. eCollection 2017.

Authors

Jong-Yi Wang¹, Chiu-Shong Liu^{2

3}, Chi-Hsuan Lung⁴, Ya-Tun Yang⁵, Ming-Hung Lin⁶

Affiliations

¹ Department of Health Services Administration, China Medical University, Taichung, Taiwan.
² Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
³ Department of Medicine, China Medical University, Taichung, Taiwan.
⁴ Department of Social Work, National Quemoy University, Kinmen, Taiwan.
⁵ Management Center, Kuang Tien General Hospital, Taichung, Taiwan.
⁶ Department of Public Health, China Medical University, Taichung, Taiwan.

Abstract

Objective: Spousal clustering of diabetes merits attention. Whether old-age vulnerability or a shared family environment determines the concordance of diabetes is also uncertain. This study investigated the spousal concordance of diabetes and compared the risk of diabetes concordance between couples and noncouples by using nationally representative data.

Methods: A total of 22,572 individuals identified from the 2002-2013 National Health Insurance Research Database of Taiwan constituted 5,643 couples and 5,643 noncouples through 1:1 dual propensity score matching (PSM). Factors associated with concordance in both spouses with diabetes were analyzed at the individual level. The risk of diabetes concordance between couples and noncouples was compared at the couple level. Logistic regression was the main statistical method. Statistical data were analyzed using SAS 9.4. C&RT and Apriori of data mining conducted in IBM SPSS Modeler 13 served as a supplement to statistics.

Results: High odds of the spousal concordance of diabetes were associated with old age, middle levels of urbanization, and high comorbidities (all P < 0.05). The dual PSM analysis revealed that the risk of diabetes concordance was significantly higher in couples (5.19%) than in noncouples (0.09%; OR = 61.743, P < 0.0001).

Conclusions: A high concordance rate of diabetes in couples may indicate the influences of assortative mating and shared environment. Diabetes in a spouse implicates its risk in the partner. Family-based diabetes care that emphasizes the screening of couples at risk of diabetes by using the identified risk factors is suggested in prospective clinical practice interventions.

MeSH terms

Adolescent
Adult
Aged
Data Mining*
Diabetes Mellitus / epidemiology*
Female
Humans
Male
Middle Aged
Spouses*
Taiwan / epidemiology
Young Adult

Grants and funding

This research was supported by Ministry of Science and Technology, Taipei, Taiwan (https://www.most.gov.tw/en/public), Grant NOs. NSC 102-2410-H-039-006-SS2 and MOST 104-2410-H-039-006 (JYW). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.