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生活方式对18-64岁人群糖尿病肾病的影响:基于2007-2018年美国国家健康与营养检查调查(NHANES)的横断面分析

Impact of lifestyle on diabetic nephropathy in aged 18-64 years: A population-based cross-sectional analysis from NHANES 2007-2018.

作者信息

Zhang Zhijun, Wei Zhaoyinling, Gao Ling

机构信息

Department of Endocrinology and Metabolism, Renmin Hospital of Wuhan University, Wuhan, China.

出版信息

J Diabetes Investig. 2025 Aug;16(8):1452-1462. doi: 10.1111/jdi.70069. Epub 2025 May 9.

Abstract

BACKGROUND

The relationship between lifestyle and overall health has garnered significant attention. This study aimed to evaluate the association between lifestyle factors and diabetic nephropathy (DN) in adults aged 18-64 years.

MATERIALS AND METHODS

We conducted a cross-sectional study involving 2,389 participants from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). The use of the Healthy Eating Index (HEI), Metabolic Equivalent of Task (MET), sleeping duration, smoking, and drinking status as indicators to assess lifestyle. Logistic regression analyses and restricted cubic splines were used to analyze the results. A subgroup analysis was performed to identify any variations.

RESULTS

Logistic regression analysis indicates that poor HEI and sleep duration but not physical activity are associated with an increased risk of DN. Subgroup analyses revealed significant interactions between HEI and age, blood pressure, HbA1c, and lipid control; MET interacted with blood pressure and HbA1c control; Sleeping duration interacted with age, smoking, blood pressure, HbA1c, and lipid control; Smoking interacted with age, blood pressure control, and lipid control; Drinking interacted with blood pressure control. Moreover, restricted cubic splines indicated that with increasing HEI, the prevalence of DN tended to decrease. However, the associations between the other two lifestyle factors (MET level and sleeping duration) and DN were all U-shaped.

CONCLUSIONS

Lifestyle factors are closely associated with diabetic nephropathy. Both unhealthy eating habits and inadequate or excessive sleeping duration and physical activity contribute to an increased risk of diabetic nephropathy, whereas no statistically significant association is observed in smoking and drinking.

摘要

背景

生活方式与整体健康之间的关系已引起广泛关注。本研究旨在评估18 - 64岁成年人生活方式因素与糖尿病肾病(DN)之间的关联。

材料与方法

我们进行了一项横断面研究,纳入了2007 - 2018年国家健康与营养检查调查(NHANES)中的2389名参与者。使用健康饮食指数(HEI)、代谢当量(MET)、睡眠时间、吸烟和饮酒状况作为评估生活方式的指标。采用逻辑回归分析和受限立方样条分析结果。进行亚组分析以确定是否存在差异。

结果

逻辑回归分析表明,HEI差和睡眠时间短与DN风险增加相关,但体力活动与DN风险增加无关。亚组分析显示,HEI与年龄、血压、糖化血红蛋白(HbA1c)和血脂控制之间存在显著交互作用;MET与血压和HbA1c控制存在交互作用;睡眠时间与年龄、吸烟、血压、HbA1c和血脂控制存在交互作用;吸烟与年龄、血压控制和血脂控制存在交互作用;饮酒与血压控制存在交互作用。此外,受限立方样条表明,随着HEI的增加,DN的患病率呈下降趋势。然而,其他两个生活方式因素(MET水平和睡眠时间)与DN之间的关联均呈U形。

结论

生活方式因素与糖尿病肾病密切相关。不健康的饮食习惯、睡眠时间不足或过长以及体力活动均会增加糖尿病肾病的风险,而吸烟和饮酒未观察到统计学上的显著关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4afa/12315247/8661b6c91f71/JDI-16-1452-g001.jpg

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