期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 107, 期 9, 页码 E3919-E3928出版社
ENDOCRINE SOC
DOI: 10.1210/clinem/dgac264
关键词
risk factors; lifestyle; diabetes mellitus; diabetes complications; mortality; cohort study
资金
- National Natural Science Foundation of China [81390540, 91846303, 82192901, 82192904, 82192900, 81941018]
- Kadoorie Charitable Foundation in Hong Kong
- UK Wellcome Trust [212946/Z/18/Z, 202922/Z/16/Z, 104085/Z/14/Z, 088158/Z/09/Z]
- National Key R&D Program of China [2016YFC0900500, 2016YFC1303904]
- Chinese Ministry of Science and Technology [2011BAI09B01]
Adopting a low-risk lifestyle is as important as achieving ideal blood pressure and glycemic goals in preventing and managing adverse outcomes related to diabetes.
Background There is an evidence gap about whether a low-risk lifestyle is as important as achieving blood pressure (BP) and random blood glucose (RBG) control. Objectives To explore the long-term impacts and relative importance of low-risk lifestyle and health factors on the risk of all-cause and cancer mortality and macrovascular and microvascular complications among patients with diabetes. Methods This study included 26,004 diabetes patients in the China Kadoorie Biobank. We defined 5 lifestyle factors (smoking, alcohol drinking, physical activity, fruit and vegetable intake, and waist-to-hip ratio) and 2 health factors (BP and RBG). Cox regression was used to yield adjusted hazard ratios (HRs) and CIs for individual and combined lifestyle and health factors with the risks of diabetes-related outcomes. Results There were 5063 deaths, 6848 macrovascular complications, and 2055 microvascular complications that occurred during a median follow-up of 10.2 years. Combined low-risk lifestyle factors were associated with lower risk of all main outcomes, with HRs (95% CIs) for participants having 4 to 5 low-risk factors vs 0 to 1 of 0.50 (0.44-0.57) for all-cause mortality, 0.55 (0.43-0.71) for cancer mortality, 0.60 (0.54-0.67) for macrovascular complications, and 0.75 (0.62-0.91) for microvascular complications. The combined 4 to 5 low-risk lifestyle factors showed relative importance in predicting all-cause and cancer mortality and macrovascular complications. Conclusions Assuming causality exists, our findings suggest that adopting a low-risk lifestyle should be regarded as important as achieving ideal BP and glycemic goals in the prevention and management of diabetes-related adverse outcomes.
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