Fretts Amanda M, Howard Barbara V, McKnight Barbara, Duncan Glen E, Beresford Shirley A A, Mete Mihriye, Zhang Ying, Siscovick David S
Department of Epidemiology, University of Washington, Seattle, WACardiovascular Health Research Unit, University of Washington, Seattle, WA
MedStar Health Research Institute, Washington, DCGeorgetown and Howard Universities Center for Clinical and Translational Research, Washington, DC.
Diabetes Care. 2014 Aug;37(8):2240-5. doi: 10.2337/dc13-2267. Epub 2014 May 7.
The American Heart Association's recommendations for optimal health, summarized in Life's Simple 7, have been associated with reduced risk of cardiovascular disease (CVD)-related end points, but no studies have examined the association of these goals with incident type 2 diabetes, which is associated with high risk for CVD. The purpose of this analysis was to examine the associations of Life's Simple 7 goals with incident diabetes among American Indians, a population at high risk of cardiometabolic diseases.
Strong Heart Family Study participants without diabetes (n = 1,639) at baseline and who participated in a follow-up examination were included in the analysis. Risk scores ranging from 0 to 7 were created using physical activity, diet, BMI, smoking, blood pressure, fasting glucose, and cholesterol metrics in accordance with Life's Simple 7 goals. Diabetes was defined using 2003 American Diabetes Association criteria, including use of insulin or oral antidiabetes medication or a follow-up fasting plasma glucose level ≥126 mg/dL. Generalized estimating equations were used to examine the association of risk scores with incident diabetes.
During a mean 5-year follow-up (range 4-8 years), we identified 210 cases of incident type 2 diabetes. Compared with participants who achieved 0-1 goals, those who achieved 2-3 or 4+ goals had lower odds of diabetes, with odds ratios = 0.40 (95% CI 0.29-0.56) and 0.11 (95% CI 0.05-0.21), respectively.
The adoption of as few as two or three Life's Simple 7 goals is associated with a lower risk of diabetes.
美国心脏协会的最佳健康建议总结在“生命简单七要素”中，这些建议与心血管疾病（CVD）相关终点风险的降低有关，但尚无研究探讨这些目标与2型糖尿病发病之间的关联，而2型糖尿病与CVD的高风险相关。本分析的目的是研究“生命简单七要素”目标与美国印第安人糖尿病发病之间的关联，美国印第安人是心血管代谢疾病的高危人群。
纳入基线时无糖尿病（n = 1639）且参加了随访检查的强心脏家族研究参与者进行分析。根据“生命简单七要素”目标，使用身体活动、饮食、体重指数、吸烟、血压、空腹血糖和胆固醇指标创建了从0到7的风险评分。糖尿病的定义采用2003年美国糖尿病协会标准，包括使用胰岛素或口服抗糖尿病药物或随访空腹血糖水平≥126mg/dL。采用广义估计方程来研究风险评分与糖尿病发病之间的关联。
在平均5年的随访期（范围4 - 8年）内，我们确定了210例2型糖尿病发病病例。与实现0 - 1个目标的参与者相比，实现2 - 3个或4个及以上目标的参与者患糖尿病的几率较低，优势比分别为0.40（95%CI 0.29 - 0.56）和0.11（95%CI 0.05 - 0.21）。
采用少至两三个“生命简单七要素”目标与较低的糖尿病风险相关。
