医学
危险系数
糖尿病
比例危险模型
全国死亡指数
生命银行
前瞻性队列研究
队列研究
队列
人口
疾病
环境卫生
内科学
人口学
置信区间
社会学
内分泌学
生物
遗传学
作者
Yanbo Zhang,Xiong‐Fei Pan,Qi Lu,Yanxiu Wang,Tingting Geng,Yanfeng Zhou,Linda M. Liao,Zhou-Zheng Tu,Jun‐Xiang Chen,Peng‐Fei Xia,Yi Wang,Zhenzhen Wan,Kunquan Guo,Kun Yang,Handong Yang,Shuohua Chen,Guodong Wang,Xu Han,Yixin Wang,Danxia Yu,Meian He,Xiaomin Zhang,Liegang Liu,Tangchun Wu,Shouling Wu,Gang Liu,An Pan
标识
DOI:10.1016/j.mayocp.2022.08.012
摘要
To prospectively examine the associations of combined lifestyle factors with incident cardiovascular disease (CVD) and mortality in patients with diabetes.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.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.The international analyses document that adherence to multicomponent healthy lifestyles is associated with lower risk of CVD and premature death of patients with diabetes.