期刊
DIABETES OBESITY & METABOLISM
卷 23, 期 4, 页码 1030-1040出版社
WILEY
DOI: 10.1111/dom.14309
关键词
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资金
- American Heart Association [17MCPRP33670728]
- US Veterans Affairs award [IK2-CX001907-01]
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the US National Institutes of Health [P30DK116073]
- European Research Council [ERC-2015CoG -681742_NASCENT]
- Doris Duke Charitable Foundation [2020096]
- NIDDK of the National Institutes of Health [U01 DK048489]
- NIDDK
- Indian Health Service
- General Clinical Research Centre Programme, National Centre for Research Resources
- Department of Veterans Affairs
- National Institute of Child Health and Human Development
- National Institute on Aging
- National Eye Institute
- National Heart Lung and Blood Institute
- National Cancer Institute
- Office of Research on Women's Health
- National Institute on Minority Health and Health Disparities
- Centres for Disease Control and Prevention
- American Diabetes Association
- Bristol-Myers Squibb
- Parke-Davis
- McKesson BioServices Corp.
- Matthews Media Group, Inc.
- Henry M. Jackson Foundation
- Novo Nordisk Foundation
The study found that individuals with lower diabetes GRS and those who achieved the ILS goals were associated with lower incidence of diabetes. Additionally, the study revealed significant additive interactions between GRS and achievement of weight loss, physical activity, and all three ILS goals for diabetes risk. The findings suggest that genetic risk can help identify high-risk subgroups who may benefit more from successful lifestyle modifications in reducing the risk of incident diabetes.
Aim To test whether diabetes genetic risk modifies the association of successful lifestyle changes with incident diabetes. Materials and methods We studied 823 individuals randomized to the intensive lifestyle intervention (ILS) arm of the Diabetes Prevention Programme who were diabetes-free 1 year after enrolment. We tested additive and multiplicative interactions of a 67-variant diabetes genetic risk score (GRS) with achievement of three ILS goals at 1 year (>= 7% weight loss, >= 150 min/wk of moderate leisure-time physical activity, and/or a goal for self-reported total fat intake) on the primary outcome of incident diabetes over 3 years of follow-up. Results A lower GRS and achieving each or all three ILS goals were each associated with lower incidence of diabetes (all P < 0.05). Additive interactions were significant between the GRS and achievement of the weight loss goal (P < 0.001), physical activity goal (P = 0.02), and all three ILS goals (P < 0.001) for diabetes risk. Achievement of all three ILS goals was associated with 1.8 (95% CI 0.3, 3.4), 3.1 (95% CI 1.5, 4.7), and 3.9 (95% CI 1.6, 6.2) fewer diabetes cases/100-person-years in the first, second and third GRS tertiles (P < 0.001 for trend). Multiplicative interactions between the GRS and ILS goal achievement were significant for the diet goal (P < 0.001), but not for weight loss (P = 0.18) or physical activity (P = 0.62) goals. Conclusions Genetic risk may identify high-risk subgroups for whom successful lifestyle modification is associated with greater absolute reduction in the risk of incident diabetes.
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