Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Front Endocrinol (Lausanne). 2022 Jun 29;13:917850. doi: 10.3389/fendo.2022.917850. eCollection 2022.
LADA is a common form of diabetes described as a mix between type 1 and type 2 diabetes. Understanding of how genes and environmental factors interact in the development of LADA is central for future efforts to prevent the disease. This review aims to synthesize the literature on lifestyle factors linked to LADA risk and discuss their potential interaction with genetic susceptibility.
Current knowledge on environmental risk factors for LADA is primarily based on observational data from Scandinavian populations. Increasing evidence suggest that lifestyle factors promoting type 2 diabetes such as obesity, sedentariness, low birth weight and smoking, is implicated in the risk of LADA. Data from mendelian randomization studies support that the link between LADA and obesity, low birth weight and smoking is causal. Limited evidence indicates that dietary factors including consumption of red meat, coffee and sweetened beverages may increase the risk while consumption of alcohol and omega-3 fatty acids may reduce the risk. Several lifestyle factors, including smoking and obesity, seem to interact with human leukocyte antigen genes associated with autoimmunity, conferring much stronger effects on disease risk among those exposed to both factors.
Available studies suggest that lifestyle modification has the potential for prevention of LADA, particularly for individuals with high risk of disease such as those with genetic susceptibility. Research into risk factors of LADA is however limited, confirmations are warranted, many factors remain to be explored, and there is a need for intervention studies to assess causality.
LADA 是一种常见的糖尿病形式,被描述为 1 型和 2 型糖尿病的混合体。了解基因和环境因素如何相互作用在 LADA 的发展中是未来预防该疾病的努力的核心。本综述旨在综合与 LADA 风险相关的生活方式因素的文献,并讨论它们与遗传易感性的潜在相互作用。
目前关于 LADA 的环境风险因素的知识主要基于斯堪的纳维亚人群的观察性数据。越来越多的证据表明,促进 2 型糖尿病的生活方式因素,如肥胖、 sedentary、低出生体重和吸烟,与 LADA 的风险有关。孟德尔随机化研究的数据支持 LADA 与肥胖、低出生体重和吸烟之间的联系是因果关系。有限的证据表明,饮食因素,包括食用红肉、咖啡和含糖饮料,可能会增加风险,而饮酒和欧米伽-3 脂肪酸可能会降低风险。一些生活方式因素,包括吸烟和肥胖,似乎与自身免疫相关的人类白细胞抗原基因相互作用,在暴露于这两种因素的人群中对疾病风险产生更强的影响。
现有研究表明,生活方式的改变有可能预防 LADA,特别是对那些具有遗传易感性的高风险疾病的个体。然而,LADA 风险因素的研究是有限的,需要进一步证实,许多因素仍有待探索,需要进行干预研究以评估因果关系。