Kolb Hubert, Martin Stephan
Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany.
West-German Centre of Diabetes and Health, Duesseldorf Catholic Hospital Group, Hohensandweg 37, 40591, Duesseldorf, Germany.
BMC Med. 2017 Jul 19;15(1):131. doi: 10.1186/s12916-017-0901-x.
Environmental and lifestyle changes, in addition to the ageing of populations, are generally believed to account for the rapid global increase in type 2 diabetes prevalence and incidence in recent decades.
In this review, we present a comprehensive overview of factors contributing to diabetes risk, including aspects of diet quality and quantity, little physical activity, increased monitor viewing time or sitting in general, exposure to noise or fine dust, short or disturbed sleep, smoking, stress and depression, and a low socioeconomic status. In general, these factors promote an increase in body mass index. Since loss of β-cell function is the ultimate cause of developing overt type 2 diabetes, environmental and lifestyle changes must have resulted in a higher risk of β-cell damage in those at genetic risk. Multiple mechanistic pathways may come into play.
Strategies of diabetes prevention should aim at promoting a 'diabetes-protective lifestyle' whilst simultaneously enhancing the resistance of the human organism to pro-diabetic environmental and lifestyle factors. More research on diabetes-protective mechanisms seems warranted.
除了人口老龄化外，环境和生活方式的改变通常被认为是近几十年来全球2型糖尿病患病率和发病率迅速上升的原因。
在本综述中，我们全面概述了导致糖尿病风险的因素，包括饮食质量和数量、身体活动不足、总体上看显示器时间增加或久坐、接触噪音或细颗粒物、睡眠不足或睡眠紊乱、吸烟、压力和抑郁以及社会经济地位低下等方面。一般来说，这些因素会促使体重指数升高。由于β细胞功能丧失是显性2型糖尿病发生的最终原因，环境和生活方式的改变必然导致有遗传风险的人群中β细胞受损的风险更高。多种机制途径可能发挥作用。
糖尿病预防策略应旨在促进“糖尿病保护性生活方式”，同时增强人体对促糖尿病环境和生活方式因素的抵抗力。似乎有必要对糖尿病保护机制进行更多研究。
