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- Yang, Rongrong (författare)
A healthy lifestyle mitigates the risk of heart disease related to type 2 diabetes : a prospective nested case-control study in a nationwide Swedish twin cohort
- Artikel/kapitelEngelska2021
Förlag, utgivningsår, omfång ...
- 2020-11-10
- Springer Science and Business Media LLC,2021
- printrdacarrier
Nummerbeteckningar
- LIBRIS-ID:oai:DiVA.org:su-188138
- https://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-188138URI
- https://doi.org/10.1007/s00125-020-05324-zDOI
- http://kipublications.ki.se/Default.aspx?queryparsed=id:145134302URI
Kompletterande språkuppgifter
- Språk:engelska
- Sammanfattning på:engelska
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- SwePubSwePub
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- Aims/hypothesis We aimed to examine the association between type 2 diabetes and major subtypes of heart disease, to assess the role of genetic and early-life familial environmental factors in this association and to explore whether and to what extent a healthy lifestyle mitigates the risk of heart disease related to type 2 diabetes.Methods In this prospective nested case-control study based on the Swedish Twin Registry, 41,463 twin individuals who were aged >= 40 and heart disease-free were followed up for 16 years (from 1998 to 2014) to detect incident heart disease. Type 2 diabetes was ascertained from self-report, the National Patient Registry and glucose-lowering medication use. Heart disease diagnosis (including coronary heart disease, cardiac arrhythmias and heart failure) and onset age were identified from the National Patient Registry. Healthy lifestyle-related factors consisted of being a non-smoker, no/mild alcohol consumption, regular physical activity and being non-overweight. Participants were divided into three groups according to the number of lifestyle-related factors: (1) unfavourable (participants who had no or only one healthy lifestyle factor); (2) intermediate (any two or three); and (3) favourable (four). Generalised estimating equation models for unmatched case-control design and conditional logistic regression for co-twin control design were used in data analyses.Results Of all participants, 2304 (5.5%) had type 2 diabetes at baseline. During the observation period, 9262 (22.3%) had any incident heart disease. In unmatched case-control analyses and co-twin control analyses, the multi-adjusted OR and 95% CI of heart disease related to type 2 diabetes was 4.36 (3.95, 4.81) and 4.89 (3.88, 6.16), respectively. The difference in ORs from unmatched case-control analyses vs co-twin control analyses was statistically significant (OR 1.57; 95% CI 1.42, 1.73; p < 0.001). In stratified analyses by type 2 diabetes, compared with an unfavourable lifestyle, an intermediate lifestyle or a favourable lifestyle was associated with a significant 32% (OR 0.68; 95% CI 0.49, 0.93) or 56% (OR 0.44; 95% CI 0.30, 0.63) decrease in heart disease risk among patients with type 2 diabetes, respectively. There were significant additive and multiplicative interactions between lifestyle and type 2 diabetes on heart disease.Conclusions/interpretation Type 2 diabetes is associated with more than fourfold increased risk of heart disease. The association still remains statistically significant, even after fully controlling for genetic and early-life familial environmental factors. However, greater adherence to a healthy lifestyle may significantly mitigate the risk of heart disease related to type 2 diabetes.
Ämnesord och genrebeteckningar
- MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi hsv//swe
- MEDICAL AND HEALTH SCIENCES Health Sciences Public Health, Global Health, Social Medicine and Epidemiology hsv//eng
- Heart disease
- Lifestyle
- Prospective nested case-control study in twins
- The Swedish Twin Registry
- Type 2 diabetes
Biuppslag (personer, institutioner, konferenser, titlar ...)
- Xu, Hui (författare)
- Pedersen, Nancy L.Karolinska Institutet (författare)
- Li, Xuerui (författare)
- Yu, Jing (författare)
- Bao, Cuiping (författare)
- Qi, Xiuying (författare)
- Xu, WeiliKarolinska Institutet,Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI),Tianjin Medical University, China (författare)
- Karolinska InstitutetCentrum för forskning om äldre och åldrande (ARC), (tills m KI) (creator_code:org_t)
Sammanhörande titlar
- Ingår i:Diabetologia: Springer Science and Business Media LLC64, s. 530-5390012-186X1432-0428
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