Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Genome Institute of Singapore, Singapore.
Am J Clin Nutr. 2020 Mar 1;111(3):698-707. doi: 10.1093/ajcn/nqz310.
Whether genetic susceptibility to type 2 diabetes is modified by a healthy lifestyle among Chinese remains unknown.
The aim of the study was to determine whether genetic risk and adherence to a healthy lifestyle contribute independently to the risk of developing type 2 diabetes.
We defined a lifestyle score using BMI, alcohol intake, smoking, physical activities, and diets in 461,030 participants from the China Kadoorie Biobank and 38,434 participants from the Singapore Chinese Health Study. A genetic risk score was constructed based on type 2 diabetes loci among 100,175 and 16,172 participants in each cohort, respectively. A Cox proportional-hazards model was used to estimate the interaction between genetic and lifestyle factors on the risk of type 2 diabetes.
In 2 independent Asian cohorts, we consistently found a healthy lifestyle (the bottom quintile of lifestyle score) was associated with a substantially lower risk of type 2 diabetes than an unhealthy lifestyle (the top quintile of lifestyle score) regardless of genetic risk. In those at a high genetic risk, the risk of type 2 diabetes was 57% lower among participants with a healthy lifestyle than among those with an unhealthy lifestyle in the pooled cohorts. Among participants at high genetic risk, the standardized 10-y incidence of type 2 diabetes was 7.11% in those with an unhealthy lifestyle vs. 2.45% in those with a healthy lifestyle.
In 2 independent cohorts involving 558,302 Chinese participants, we did not observe an interaction between genetics and lifestyle with type 2 diabetes risk, but our findings provide replicable evidence to show lifestyle factors and genetic factors were independently associated with the risk of type 2 diabetes. Within any genetic risk category, a healthy lifestyle was associated with a significantly lower risk of type 2 diabetes among the Chinese population.
在中国人群中，2 型糖尿病的遗传易感性是否会受到健康生活方式的影响尚不清楚。
本研究旨在确定遗传风险和遵循健康生活方式是否独立影响 2 型糖尿病的发病风险。
我们在来自中国慢性病前瞻性研究（CKB）的 461030 名参与者和来自新加坡华人健康研究（SCHS）的 38434 名参与者中，使用 BMI、饮酒、吸烟、身体活动和饮食定义了生活方式评分。根据两个队列中 100175 名和 16172 名参与者的 2 型糖尿病相关基因座构建了遗传风险评分。采用 Cox 比例风险模型估计遗传和生活方式因素对 2 型糖尿病发病风险的交互作用。
在两个独立的亚洲队列中，无论遗传风险如何，我们都发现健康的生活方式（生活方式评分最低五分位）与 2 型糖尿病的发病风险显著降低相关，而不健康的生活方式（生活方式评分最高五分位）则与 2 型糖尿病的发病风险显著相关。在遗传风险较高的人群中，与不健康的生活方式相比，生活方式健康的参与者发生 2 型糖尿病的风险降低了 57%。在遗传风险较高的参与者中，不健康生活方式者的 2 型糖尿病标准化 10 年发病率为 7.11%，而健康生活方式者的发病率为 2.45%。
在涉及 558302 名中国参与者的两个独立队列中，我们没有观察到遗传因素和生活方式与 2 型糖尿病风险之间存在交互作用，但我们的研究结果提供了可重复的证据，表明生活方式因素和遗传因素与 2 型糖尿病的发病风险独立相关。在任何遗传风险类别中，健康的生活方式都与中国人群 2 型糖尿病的发病风险显著降低相关。
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