Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Diabetes Metab Syndr. 2024 Jul;18(7):103090. doi: 10.1016/j.dsx.2024.103090. Epub 2024 Jul 26.
To investigate whether and what lifestyle factors in later life modify the associations of early-life smoking behaviors and genetic susceptibility with type 2 diabetes (T2D).
In the UK Biobank, in utero tobacco exposure (n = 354,493) and age of smoking initiation (n = 353,557) were self-reported. A composite lifestyle score was calculated based on diet, physical activity, nicotine exposure, sleep duration, and BMI. Hazard ratio (HR) and absolute risk difference (ARD) were used to estimate the associations of early-life smoking behaviors and genetic risk with incident T2D, as well as the effect modification of the lifestyle score.
During a median follow-up of 14.6 years, the HRs (95 % CIs) of T2D for in utero tobacco exposure, and smoking initiation in adulthood, adolescence, and childhood, compared with no smoking behavior, were 1.19 (1.16-1.23), 1.34 (1.29-1.39), 1.58 (1.53-1.64), 2.22 (2.11-2.32), respectively (P for trend<0.001). Early-life smoking behaviors and high genetic risk (vs no smoking behavior and low genetic risk) were associated with a 302%-593 % higher T2D risk (P for additive interaction<0.05). Compared to participants with early-life smoking behaviors, high genetic risk, and an unfavorable lifestyle, those who adhered to a favorable lifestyle had a lower T2D risk in all subgroups (HRs from 0.05 to 0.36 and ARD from -14.97 % to -9.51 %), with the highest ARD attributable to lifestyle in participants with early-life smoking behaviors and high genetic risk.
The T2D risk associated with early-life smoking behaviors and genetic risk was modified by a favorable lifestyle.
研究晚年生活中的哪些生活方式因素会改变早期吸烟行为和遗传易感性与 2 型糖尿病（T2D）之间的关联。
在英国生物库中，自我报告了胎儿期的烟草暴露（n=354493）和吸烟起始年龄（n=353557）。基于饮食、体力活动、尼古丁暴露、睡眠时间和 BMI 计算了综合生活方式评分。使用危害比（HR）和绝对风险差异（ARD）来估计早期吸烟行为和遗传风险与 T2D 发病的关联，以及生活方式评分的效应修饰。
在中位随访 14.6 年期间，与无吸烟行为相比，胎儿期烟草暴露和成年期、青春期和儿童期吸烟起始的 T2D 风险 HR（95%CI）分别为 1.19（1.16-1.23）、1.34（1.29-1.39）、1.58（1.53-1.64）、2.22（2.11-2.32）（P<0.001）。早期吸烟行为和高遗传风险（与无吸烟行为和低遗传风险相比）与 T2D 风险增加 302%-593%相关（P 值<0.05，加性交互作用）。与有早期吸烟行为、高遗传风险和不良生活方式的参与者相比，所有亚组中坚持有利生活方式的参与者的 T2D 风险较低（HR 范围为 0.05 至 0.36，ARD 范围为-14.97%至-9.51%），在有早期吸烟行为和高遗传风险的参与者中，归因于生活方式的 ARD 最高。
早期吸烟行为和遗传风险与 T2D 风险的关联受有利生活方式的影响。
