National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
Ann Intern Med. 2011 Sep 6;155(5):292-9. doi: 10.7326/0003-4819-155-5-201109060-00006.
Epidemiologic data on the combined influence of several lifestyle factors on diabetes risk are rare, particularly among older adults.
To examine how combinations of lifestyle risk factors relate to the 11-year risk for incident diabetes.
Population-based prospective cohort study.
National Institutes of Health (NIH)-AARP Diet and Health Study.
114,996 men and 92,483 women, aged 50 to 71 years in 1995 to 1996, without evidence of heart disease, cancer, or diabetes.
A comprehensive survey of demographic characteristics and lifestyle factors, including dietary intake, body weight and height, physical activity, smoking, and alcohol consumption at baseline (1995 to 1996). Low-risk groups were formed by dichotomizing each lifestyle factor. Incident self-reported, physician-diagnosed diabetes was identified with a follow-up survey in 2004 to 2006.
11,031 men (9.6%) and 6969 women (7.5%) developed new-onset diabetes. For each additional lifestyle factor in the low-risk group, the odds for diabetes were 31% lower (odds ratio [OR], 0.69 [95% CI, 0.68 to 0.71]) among men and 39% lower (OR, 0.61 [CI, 0.60 to 0.63]) among women. Men and women whose diet score, physical activity level, smoking status, and alcohol use were all in the low-risk group had ORs for diabetes of 0.61 (CI, 0.56 to 0.66) and 0.43 (CI, 0.34 to 0.55), respectively. When absence of overweight or obesity was added, the respective ORs were 0.28 (CI, 0.23 to 0.34) and 0.16 (CI, 0.10 to 0.24) for men and women. Results did not differ by family history of diabetes or level of adiposity.
The study was observational, with potential for residual confounding.
Lifestyle factors, when considered in combination, are associated with a substantial reduction in risk for diabetes.
The NIH-AARP Diet and Health Study was supported by the Intramural Research Program of the NIH.
关于几种生活方式因素对糖尿病风险的综合影响的流行病学数据很少，尤其是在老年人中。
研究生活方式危险因素的组合与 11 年内新发糖尿病的风险之间的关系。
基于人群的前瞻性队列研究。
美国国立卫生研究院（NIH）-AARP 饮食与健康研究。
1995 年至 1996 年间，年龄在 50 至 71 岁之间的 114996 名男性和 92483 名女性，无心脏病、癌症或糖尿病证据。
在基线（1995 年至 1996 年）时进行了全面的人口统计学特征和生活方式因素调查，包括饮食摄入、体重和身高、身体活动、吸烟和饮酒。通过将每个生活方式因素二分为低风险组来形成低风险组。通过 2004 年至 2006 年的随访调查，确定了新发生的自我报告的、医生诊断的糖尿病。
11031 名男性（9.6%）和 6969 名女性（7.5%）发生新发糖尿病。在低风险组中，每增加一种生活方式因素，男性患糖尿病的几率降低 31%（比值比[OR]，0.69[95%CI，0.68 至 0.71]），女性降低 39%（OR，0.61[CI，0.60 至 0.63]）。饮食评分、身体活动水平、吸烟状况和饮酒均处于低风险组的男性和女性，糖尿病的 OR 分别为 0.61（CI，0.56 至 0.66）和 0.43（CI，0.34 至 0.55）。当不超重或肥胖时，男性和女性的相应 OR 分别为 0.28（CI，0.23 至 0.34）和 0.16（CI，0.10 至 0.24）。结果不因糖尿病家族史或肥胖程度而异。
该研究为观察性研究，存在潜在的残余混杂。
生活方式因素综合考虑时，与糖尿病风险的大幅降低相关。
NIH-AARP 饮食与健康研究由 NIH 内部研究计划提供支持。
