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Individual and Combined Associations of Modifiable Lifestyle and Metabolic Health Status With New-Onset Diabetes and Major Cardiovascular Events: The China Cardiometabolic Disease and Cancer Cohort (4C) Study

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单位: [1]Shanghai Jiao Tong Univ, Ruijin Hosp,Dept Endocrine & Metab Dis, Shanghai Natl Clin Res Ctr Metab Dis,Natl Hlth Co, Shanghai Natl Ctr Translat Med,Sch Med,Key Lab En, Shanghai, Peoples R China [2]Southwest Med Univ, Affiliated Hosp, Luzhou, Peoples R China [3]Wenzhou Med Univ, Affiliated Hosp 1, Wenzhou, Peoples R China [4]Dalian Med Univ, Dalian Municipal Cent Hosp, Dalian, Peoples R China [5]Fujian Med Univ, Fujian Prov Hosp, Fuzhou, Peoples R China [6]Shandong Univ, Shandong Prov Hosp, Jinan, Peoples R China [7]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Wuhan, Peoples R China [8]Guiyang Med Coll, Affiliated Hosp, Guiyang, Peoples R China [9]Zhejiang Prov Ctr Dis Control & Prevent, Hangzhou, Peoples R China [10]Lanzhou Univ, Hosp 1, Lanzhou, Peoples R China [11]Shanghai Jiao Tong Univ, Sch Med, Xinhua Hosp, Shanghai, Peoples R China [12]Zhengzhou Univ, Affiliated Hosp 1, Zhengzhou, Peoples R China [13]First Hosp Jilin Univ, Changchun, Peoples R China [14]Guangxi Med Univ, Affiliated Hosp 1, Nanning, Peoples R China [15]Nanchang Univ, Jiangxi Prov Peoples Hosp, Nanchang, Jiangxi, Peoples R China [16]Harbin Med Univ, Affiliated Hosp 2, Harbin, Peoples R China [17]Cent Hosp Shanghai Jiading Dist, Shanghai, Peoples R China [18]Jiangsu Prov Hosp Integrat Chinese & Western Med, Nanjing, Peoples R China [19]Chinese Peoples Liberat Army Gen Hosp, Beijing, Peoples R China [20]Anhui Med Univ, Affiliated Hosp 1, Hefei, Peoples R China [21]Karamay Municipal Peoples Hosp, Xinjiang, Peoples R China [22]Nanjing Med Univ, Affiliated Hosp 1, Nanjing, Peoples R China [23]Shandong Univ, Qilu Hosp, Jinan, Peoples R China [24]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China [25]Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Peoples R China [26]Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China
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OBJECTIVE We aimed to determine the individual and combined associations of lifestyle and metabolic factors with new-onset diabetes and major cardiovascular events among a Chinese population aged >= 40 years. RESEARCH DESIGN AND METHODS Baseline lifestyle information, waist circumference, blood pressure, lipid profiles, and glycemic status were obtained in a nationwide, multicenter, prospective study of 170,240 participants. During the up to 5 years of follow-up, we detected 7,847 individuals with new-onset diabetes according to the American Diabetes Association 2010 criteria and 3,520 cardiovascular events, including cardiovascular death, myocardial infarction, stroke, and hospitalized or treated heart failure. RESULTS On the basis of 36.13% (population-attributable fraction [PAF]) risk attributed to metabolic risk components collectively, physical inactivity (8.59%), sedentary behavior (6.35%), and unhealthy diet (4.47%) moderately contributed to incident diabetes. Physical inactivity (13.34%), unhealthy diet (8.70%), and current smoking (3.38%) significantly contributed to the risk of major cardiovascular events, on the basis of 37.42% PAF attributed to a cluster of metabolic risk factors. Significant associations of lifestyle health status with diabetes and cardiovascular events were found across all metabolic health categories. Risks of new-onset diabetes and major cardiovascular events increased simultaneously according to the worsening of lifestyle and metabolic health status. CONCLUSIONS We showed robust effects of lifestyle status on new-onset diabetes and major cardiovascular events regardless of metabolic status and a graded increment of risk according to the combination of lifestyle and metabolic health, highlighting the importance of lifestyle modification regardless of the present metabolic status.

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出版当年[2019]版:
大类 | 1 区 医学
小类 | 1 区 内分泌学与代谢
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 内分泌学与代谢
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出版当年[2018]版:
Q1 ENDOCRINOLOGY & METABOLISM
最新[2023]版:
Q1 ENDOCRINOLOGY & METABOLISM

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第一作者单位: [1]Shanghai Jiao Tong Univ, Ruijin Hosp,Dept Endocrine & Metab Dis, Shanghai Natl Clin Res Ctr Metab Dis,Natl Hlth Co, Shanghai Natl Ctr Translat Med,Sch Med,Key Lab En, Shanghai, Peoples R China
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