Causation or Assortative Mating - The Social Dynamics in Couples With Both Partners Suffering from the Same Lifestyle Disease : A Case Series Study From a German Cohort Study of Type 2 Diabetes Mellitus Patients in a Disease Management Programme.
As has been established in previous research that living in a relationship with a person suffering from Type 2 Diabetes mellitus increases the risk of developing the disease yourself. However, the reason for this increased risk has not been observed in any of these studies. A large study (n=398), w...
Medizinische Soziologie und Sozialmedizin
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|Summary:||As has been established in previous research that living in a relationship with a person suffering from Type 2 Diabetes mellitus increases the risk of developing the disease yourself. However, the reason for this increased risk has not been observed in any of these studies.
A large study (n=398), which had the objective to compare the impact of a new care programme in the context of a disease management programme of T2DM patients, also showed a large number of diabetic couples. This study population was used in this study to research the potential causation of the increased T2DM risk in couples. The hypothesis was therefore: ‘A person with T2DM is causal for the elevated risk of his or her spouse to develop T2DM as well’.
In order to distinguish, in observational studies, whether there are causal or non-causal associations in the genesis of a disease the Bradford Hill criteria were utilized and the research attempted to apply each criterion to this set of data to see whether a causality was likely.
Firstly, all couples from the set of data were identified by matching their last names and addresses (18 couples, 36 individuals). These couples were then contacted and invited to join an interview in order to gain as much information about their mutual lives and T2DM risk factors as possible. Not all couples agreed to participate in an interview, creating 3 data set groups:
• Interviewed couples.
• Not-interviewed couples.
• The patients from the large set of data not known to be in a relationship with a T2DM patient.
These 3 groups were then observed and compared in order to see differences and similarities between and within them. These observations were analysed taking into account the Bradford Hill criteria.
The results show that the hypothesis does not seem to be true. There does not seem to be a causal association between a partner developing T2DM when married to a T2DM patient. The reason can rather be explained by assortative mating, meaning that people with similar circumstances of life (such as socio- economic status, obesity and low physical activity) are likely to mate among themselves.
In conclusion, it can be stated that a marriage partner with a manifest T2DM may be a marker, but not a causal agent for an increased T2DM risk.|
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