| Title: | Association of Combined Healthy Lifestyles With Cardiovascular Disease and Mortality of Patients With Diabetes: An International Multicohort Study |
| Journal: | Mayo Clinic Proceedings |
| Published: | 1 Jan 2023 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/36603958/ |
| DOI: | https://doi.org/10.1016/j.mayocp.2022.08.012 |
Publication 10893
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
OBJECTIVE: To prospectively examine the associations of combined lifestyle factors with incident cardiovascular disease (CVD) and mortality in patients with diabetes.</p>
PATIENTS AND METHODS: Patients with prevalent diabetes were included from 5 prospective, population-based cohorts in China (Dongfeng-Tongji cohort and Kailuan study), the United Kingdom (UK Biobank study), and the United States (National Health and Nutrition Examination Survey and National Institutes of Health-AARP Diet and Health Study). Healthy lifestyle scores were constructed according to non-current smoking, low to moderate alcohol drinking, regular physical activity, healthy diet, and optimal body weight; the healthy level of each lifestyle factor was assigned 1 point, or 0 for otherwise, and the range of the score was 0 to 5. Cox proportional hazards models were used to estimate hazard ratios for incident CVD, CVD mortality, and all-cause mortality adjusting for sociodemographic, medical, and diabetes-related factors, and outcomes were obtained by linkage to medical records and death registries. Data were collected from October 18, 1988, to September 30, 2020.</p>
RESULTS: A total of 6945 incident CVD cases were documented in 41,350 participants without CVD at baseline from the 2 Chinese cohorts and the UK Biobank during 389,330 person-years of follow-up, and 40,353 deaths were documented in 101,219 participants from all 5 cohorts during 1,238,391 person-years of follow-up. Adjusted hazard ratios (95% CIs) comparing patients with 4 or 5 vs 0 or 1 healthy lifestyle factors were 0.67 (0.60 to 0.74) for incident CVD, 0.58 (0.50 to 0.68) for CVD mortality, and 0.60 (0.53 to 0.68) for all-cause mortality. Findings remained consistent across different cohorts, subgroups, and sensitivity analyses.</p>
CONCLUSION: The international analyses document that adherence to multicomponent healthy lifestyles is associated with lower risk of CVD and premature death of patients with diabetes.</p>
27 Authors
- Yan-Bo Zhang
- Xiong-Fei Pan
- Qi Lu
- Yan-Xiu Wang
- Ting-Ting Geng
- Yan-Feng Zhou
- Linda M Liao
- Zhou-Zheng Tu
- Jun-Xiang Chen
- Peng-Fei Xia
- Yi Wang
- Zhen-Zhen Wan
- Kun-Quan Guo
- Kun Yang
- Han-Dong Yang
- Shuo-Hua Chen
- Guo-Dong Wang
- Xu Han
- Yi-Xin Wang
- Danxia Yu
- Mei-An He
- Xiao-Min Zhang
- Lie-Gang Liu
- Tangchun Wu
- Shou-Ling Wu
- Gang Liu
- An Pan
Enabling scientific discoveries that improve human health