Risk of metabolic syndrome and diabetes among young twins and singletons in Guinea-Bissau.
OBJECTIVE
Twins 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.


METHODS
The 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.


RESULTS
HbA1c 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).


CONCLUSIONS
The 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.
Corresponding author: Morten Bjerregaard-Andersen, mban@dadlnet.dk.
Morten
M
Bjerregaard-Andersen
Lone
L
Hansen
Leontina I
LI
da Silva
Luis C
LC
Joaquím
Ditte E
DE
Hennild
Lene
L
Christiansen
Peter
P
Aaby
Christine S
CS
Benn
Kaare
K
Christensen
Morten
M
Sodemann
Dorte M
DM
Jensen
Henning
H
Beck-Nielsen
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006169:Guinea-Bissau / Q000453:epidemiology; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D012306:Risk; D012307:Risk Factors; D014427:Twins; D055815:Young Adult
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human