CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China.
State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.
Diabetes Care. 2022 Feb 1;45(2):319-329. doi: 10.2337/dc21-1512.
To evaluate the association of a healthy lifestyle, involving seven low-risk factors mentioned in diabetes management guidelines (no current smoking, moderate alcohol consumption, regular physical activity, healthy diet, less sedentary behavior, adequate sleep duration, and appropriate social connection), with all-cause and cause-specific mortality among individuals with type 2 diabetes.
This study included 13,366 participants with baseline type 2 diabetes from the UK Biobank free of cardiovascular disease (CVD) and cancer. Lifestyle information was collected through a baseline questionnaire.
During a median follow-up of 11.7 years, 1,561 deaths were documented, with 625 from cancer, 370 from CVD, 115 from respiratory disease, 81 from digestive disease, and 74 from neurodegenerative disease. In multivariate-adjusted model, each lifestyle factor was significantly associated with all-cause mortality, and hazard ratios associated with the lifestyle score (scoring 6-7 vs. 0-2 unless specified) were 0.42 (95% CI 0.34, 0.52) for all-cause mortality, 0.57 (0.41, 0.80) for cancer mortality, 0.35 (0.22, 0.56) for CVD mortality, 0.26 (0.10, 0.63) for respiratory mortality, and 0.28 (0.14, 0.53) for digestive mortality (scoring 5-7 vs. 0-2). In the population-attributable risk analysis, 29.4% (95% CI 17.9%, 40.9%) of deaths were attributable to a poor lifestyle (scoring 0-5). The association between a healthy lifestyle and all-cause mortality was consistent, irrespective of factors reflecting diabetes severity (diabetes duration, glycemic control, diabetes-related microvascular disease, and diabetes medication).
A healthy lifestyle was associated with a lower risk of all-cause mortality and mortality due to CVD, cancer, respiratory disease, and digestive disease among individuals with type 2 diabetes.
评估健康的生活方式与 2 型糖尿病患者全因死亡率和死因特异性死亡率之间的关联，这种生活方式涉及糖尿病管理指南中提到的七个低风险因素（无当前吸烟、适量饮酒、定期身体活动、健康饮食、减少久坐行为、充足的睡眠时间和适当的社交联系）。
这项研究纳入了英国生物库中无心血管疾病（CVD）和癌症的 13366 名基线 2 型糖尿病患者。生活方式信息通过基线问卷收集。
在中位随访 11.7 年期间，记录到 1561 例死亡，其中 625 例死于癌症，370 例死于 CVD，115 例死于呼吸疾病，81 例死于消化疾病，74 例死于神经退行性疾病。在多变量调整模型中，每个生活方式因素与全因死亡率显著相关，与生活方式评分相关的风险比（评分 6-7 与 0-2，除非另有说明）分别为：全因死亡率 0.42（95%CI 0.34，0.52）、癌症死亡率 0.57（0.41，0.80）、CVD 死亡率 0.35（0.22，0.56）、呼吸死亡率 0.26（0.10，0.63）和消化死亡率 0.28（0.14，0.53）（评分 5-7 与 0-2）。在人群归因风险分析中，29.4%（95%CI 17.9%，40.9%）的死亡归因于不良生活方式（评分 0-5）。健康生活方式与全因死亡率之间的关联是一致的，无论反映糖尿病严重程度的因素（糖尿病病程、血糖控制、糖尿病相关微血管疾病和糖尿病药物治疗）如何。
健康的生活方式与 2 型糖尿病患者的全因死亡率以及 CVD、癌症、呼吸疾病和消化疾病相关死亡率降低相关。
