期刊
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
卷 46, 期 5, 页码 1410-1420出版社
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyx074
关键词
diabetes mellitus; type 2; cohort studies; health behaviour; lifestyle
资金
- National Natural Science Foundation of China [81390540, 81390544, 81390541]
- Kadoorie Charitable Foundation in Hong Kong
- UK Wellcome Trust [088158/Z/09/Z, 104085/Z/14/Z]
- Chinese Ministry of Science and Technology [2011BAI09B01]
- State Scholarship Fund of China Scholarship Council [201506015053]
- NIH grants from the National Heart, Lung, and Blood Institute [HL071981, HL034594, HL126024, HL132254]
- National Institute of Diabetes and Digestive and Kidney Diseases [DK091718, DK100383, DK078616]
- Boston Obesity Nutrition Research Center [DK46200]
- USA-Israel Binational Science Foundation [2011036]
- American Heart Association Scientist Development Award [0730094N]
- Medical Research Council [MC_UU_12026/2, MC_U137686851] Funding Source: researchfish
- MRC [MC_UU_12026/2, MC_U137686851] Funding Source: UKRI
Background: Simultaneously adhering to multiple healthy lifestyle factors has been related to up to 90% reduction in type 2 diabetes (T2DM) incidence in White populations; however, little is known about whether such protective effects persist in other non-White populations. Methods: We examined the associations of six lifestyle factors with T2DM in the China Kadoorie Biobank of 461 211 participants aged 30-79 years without diabetes, cardiovascular diseases or cancer at baseline. We defined low-risk lifestyle factors as nonsmoking or having stopped for reasons other than illness; alcohol consumption of <30 g/day; upper quarter of the physical activity level; diet rich in vegetables and fruits, low in red meat and with some degree of replacement of rice with wheat; body mass index (BMI) of 18.5-23.9 kg/m(2); and waist-to-hip ratio (WHR) <0.90 (men)/ <0.85 (women). Results: During a median of 7.2 years of follow-up, we identified 8784 incident T2DM. In multivariable-adjusted analyses, two important risk factors for developing T2DM were higher BMI and WHR. Compared with participants without any low-risk factors, the hazard ratio [95% confidence interval (CI)] for those with at least three low-risk factors was0.20 (0.19, 0.22). Approximately 72.6% (64.2%, 79.3%) of the incident diabetes were attributable to the combination of BMI, WHR, diet and physical activity. The population attributable risk percentage (PAR%) of diabetes appeared to be similar for men and women, and higher among urban, older and obese participants. Conclusions: Our findings indicate that adherence to a healthy lifestyle may substantially lower the burden of T2DM in the Chinese population.
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