生活方式评分与糖尿病患者心血管代谢标志物的相关性：一项横断面研究。
Association of a lifestyle score with cardiometabolic markers among individuals with diabetes: a cross-sectional study.
机构信息
Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany.
German Center for Diabetes Research (DZD), Partner Duesseldorf, Muenchen-Neuherberg, Germany.
出版信息
BMJ Open Diabetes Res Care. 2023 Jul;11(4). doi: 10.1136/bmjdrc-2023-003469.
INTRODUCTION
To investigate the associations of a lifestyle score with various cardiovascular risk markers, indicators for fatty liver disease as well as MRI-determined total, subcutaneous and visceral adipose tissue mass in adults with new-onset diabetes.
RESEARCH DESIGN AND METHODS
This cross-sectional analysis included 196 individuals with type 1 (median age: 35 years; median body mass index (BMI): 24 kg/m²) and 272 with type 2 diabetes (median age: 53 years; median BMI: 31 kg/m²) from the German Diabetes Study. A healthy lifestyle score was generated based on healthy diet, moderate alcohol consumption, recreational activity, non-smoking and non-obese BMI. These factors were summed to form a score ranging from 0 to 5. Multivariable linear and non-linear regression models were used.
RESULTS
In total, 8.1% of the individuals adhered to none or one, 17.7% to two, 29.7% to three, 26.7% to four, and 17.7% to all five favorable lifestyle factors. High compared with low adherence to the lifestyle score was associated with more favorable outcome measures, including triglycerides (β (95% CI) -49.1 mg/dL (-76.7; -21.4)), low-density lipoprotein (-16.7 mg/dL (-31.3; -2.0)), and high-density lipoprotein cholesterol (13.5 mg/dL (7.6; 19.4)), glycated hemoglobin (-0.5% (-0.8%; -0.1%)), high-sensitivity C reactive protein (-0.4 mg/dL (-0.6; -0.2)), as well as lower hepatic fat content (-8.3% (-11.9%; -4.7%)), and visceral adipose tissue mass (-1.8 dm³ (-2.9; -0.7)). The dose-response analyses showed that adherence to every additional healthy lifestyle factor was associated with more beneficial risk profiles.
CONCLUSIONS
Adherence to each additional healthy lifestyle factor was beneficially associated with cardiovascular risk markers, indicators of fatty liver disease and adipose tissue mass. Strongest associations were observed for adherence to all healthy lifestyle factors in combination.
TRIAL REGISTRATION NUMBER
NCT01055093.
简介
本研究旨在探讨生活方式评分与新诊断糖尿病成人的各种心血管风险标志物、脂肪肝指标以及 MRI 测定的总、皮下和内脏脂肪组织质量之间的关联。
研究设计和方法
本横断面分析纳入了来自德国糖尿病研究的 196 名 1 型糖尿病患者（中位年龄：35 岁；中位体重指数（BMI）：24kg/m²）和 272 名 2 型糖尿病患者（中位年龄：53 岁；中位 BMI：31kg/m²）。基于健康饮食、适量饮酒、休闲活动、不吸烟和非肥胖 BMI，生成了一个健康生活方式评分。这些因素相加得到一个 0 到 5 的评分。采用多元线性和非线性回归模型。
结果
总共，8.1%的人不遵守或仅遵守一个、17.7%的人遵守两个、29.7%的人遵守三个、26.7%的人遵守四个、17.7%的人遵守全部五个有利的生活方式因素。与低生活方式评分相比，高生活方式评分与更有利的结果指标相关，包括甘油三酯（-49.1mg/dL[-76.7；-21.4]）、低密度脂蛋白（-16.7mg/dL[-31.3；-2.0]）和高密度脂蛋白胆固醇（13.5mg/dL[7.6；19.4]）、糖化血红蛋白（-0.5%[-0.8%；-0.1%]）、高敏 C 反应蛋白（-0.4mg/dL[-0.6；-0.2]）以及更低的肝脂肪含量（-8.3%[-11.9%；-4.7%]）和内脏脂肪组织量（-1.8dm³[-2.9；-0.7]）。剂量反应分析表明，每增加一个健康生活方式因素与更有益的风险特征相关。
结论
每增加一个健康生活方式因素与心血管风险标志物、脂肪肝指标和脂肪组织量均呈正相关。最强的关联见于所有健康生活方式因素的综合。
临床试验注册号
NCT01055093。
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