Associations of Combined Healthy Lifestyle Factors with Risks of Diabetes, Cardiovascular Disease, Cancer, and Mortality Among Adults with Prediabetes: Four Prospective Cohort Studies in China, the United Kingdom, and the United States

Tu, Zhou-Zheng; Lu, Qi; Zhang, Yanbo; Shu, Zhe; Lai, Yu-Wei; Ma, Meng-Nan; Xia, Peng‐Fei; Geng, Tingting; Chen, Jun-Xiang; Li, Yue; Wu, Leilei; Ouyang, Jing; Rong, Zhi hui; Ding, Xiong; Chen, Shuohua; He, Meian; Zhang, Xiaomin; Liu, Liegang; Wu, Tangchun; Wu, Shouling; Liu, Gang; Pan, An

doi:10.1016/j.eng.2022.04.010

Cited by 6 publications

(2 citation statements)

References 40 publications

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“…Although lifestyle behaviors that are generally recommended, e.g., normal weight, no smoking, moderate alcohol drinking, healthy diet, and physically active, have been associated with lower risks of microvascular complications [8][9][10][11][12][13][14], to our best knowledge, the magnitudes of the joint association of multiple lifestyle factors with the development of microvascular complications in diabetes have not yet been quantified, which may have substantial public health implications on translating epidemiological findings to meaningful public health actions. In addition, several studies have linked lifestyle behaviors with a range of intermediate variables including lipid profile [15,16], liver function biomarkers [15,[17][18][19], renal function biomarkers [20,21], blood pressure indices [22], glucose metabolism measures [23], and systemic inflammatory factors [15,16]; however, whether and the extent to which these metabolic biomarkers could mediate the association between lifestyle behaviors and diabetic microvascular complications remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Healthy lifestyle behaviors, mediating biomarkers, and risk of microvascular complications among individuals with type 2 diabetes: A cohort study

Geng

Zhu

et al. 2023

PLoS Med

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Background The influence of overall lifestyle behaviors on diabetic microvascular complications remains unknown. In addition, the potential mediating biomarkers underlying the association is unclear. This study aimed to examine the associations of the combined lifestyle factors with risks of total and individual microvascular complications among patients with type 2 diabetes (T2D) and to explore the potential mediation effects of metabolic biomarkers. Methods and findings This retrospective cohort study included 15,104 patients with T2D free of macro- and microvascular complications at baseline (2006 to 2010) from the UK Biobank. Healthy lifestyle behaviors included noncurrent smoking, recommended waist circumference, regular physical activity, healthy diet, and moderate alcohol drinking. Outcomes were ascertained using electronic health records. Over a median of 8.1 years of follow-up, 1,296 cases of the composite microvascular complications occurred, including 558 diabetic retinopathy, 625 diabetic kidney disease, and 315 diabetic neuropathy, with some patients having 2 or 3 microvascular complications simultaneously. After multivariable adjustment for sociodemographic characteristics, history of hypertension, glycemic control, and medication histories, the hazard ratios (95% confidence intervals (CIs)) for the participants adhering 4 to 5 low-risk lifestyle behaviors versus 0 to 1 were 0.65 (0.46, 0.91) for diabetic retinopathy, 0.43 (0.30, 0.61) for diabetic kidney disease, 0.46 (0.29, 0.74) for diabetic neuropathy, and 0.54 (0.43, 0.68) for the composite outcome (all Ps-trend ≤0.01). Further, the population-attributable fraction (95% CIs) of diabetic microvascular complications for poor adherence to the overall healthy lifestyle (<4 low-risk factors) ranged from 25.3% (10.0%, 39.4%) to 39.0% (17.7%, 56.8%). In addition, albumin, HDL-C, triglycerides, apolipoprotein A, C-reactive protein, and HbA1c collectively explained 23.20% (12.70%, 38.50%) of the associations between overall lifestyle behaviors and total diabetic microvascular complications. The key limitation of the current analysis was the potential underreporting of microvascular complications because the cases were identified via electronic health records. Conclusions Adherence to overall healthy lifestyle behaviors was associated with a significantly lower risk of microvascular complications in patients with T2D, and the favorable associations were partially mediated through improving biomarkers of glycemic control, systemic inflammation, liver function, and lipid profile.

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Section: Introductionmentioning

confidence: 99%

Healthy lifestyle behaviors, mediating biomarkers, and risk of microvascular complications among individuals with type 2 diabetes: A cohort study

Geng

Zhu

et al. 2023

PLoS Med

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“…Caring for Patients with Type II Diabetes Mellitus: A Nursing Case Report behavior to become more empowered Charles Shapu, Ismail, Ahmad, Lim, & Abubakar Njodi, (2020) and have control and be able to make decisions about their health status Idoko, Idoko, & Chidolue, (2019) his health because lifestyle intervention is an effective measure for diabetes prevention in high-risk individuals with prediabetes (Tu et al, 2022). As the third day progressed, the participants discussed the necessity of adhering to a particular diet and lifestyle.…”

Section: Changes Inmentioning

confidence: 99%

Caring for Patients with Type II Diabetes Mellitus: A Nursing Case Report

Era

2023

Injurity

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Diabetes Mellitus (DM) is a disease characterized by an insufficient amount of insulin that does not function normally. According to data of Basic Health Research of Indonesia Government year 2018, the global prevalence of DM among those aged 55 to 64 years reached 6.3% of 265 individuals, the highest value among all other age groups. To present a case study with TTDM in Samarinda, Indonesia and to determine the nursing care plan, explaining the nursing interventions and showing the importance of nursing care of patients with DM. we treated 2 patients who had TTDM using a standardized nursing process for 3 days and made observations and recorded the similarities and differences that emerged as a result of disease response and the effects of the treatment provided. Researcher has completed collecting data set which was then used to establish each of the 6 nursing diagnoses, and further each nursing plan details implemented and evaluated. There is a diversity and resemblance of data that was revealed in the discussion session of ther report. Using a thematic analysis approach, patterns in the data were identified and analyzed. The data were then synthesized using Indonesian Nursing Standardized (3S) terminology. The patient's positive health outcomes supported the accuracy of the diagnoses and the appropriateness of the nursing interventions. case study method contributes in understanding the overall nursing care for patients, especially those with TTDM because it opened up nursing scenarios that support nurses in utilized critical thinking skills including in making decisions in the use of the entire nursing process. By carefully implementing chosen interventions through nursing process nurse was able to compare data between cases, to determine the causes of differences and similarities from the data obtained and analyze based on appropriate theories and concepts.

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Impact of health practice index and cardiovascular health metrics on incident cardiovascular disease according to glucose tolerance status

Murai,

Fujihara,

Harada Yamada

et al. 2024

Diabetol Int

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Associations of Combined Healthy Lifestyle Factors with Risks of Diabetes, Cardiovascular Disease, Cancer, and Mortality Among Adults with Prediabetes: Four Prospective Cohort Studies in China, the United Kingdom, and the United States

Cited by 6 publications

References 40 publications

Healthy lifestyle behaviors, mediating biomarkers, and risk of microvascular complications among individuals with type 2 diabetes: A cohort study

Healthy lifestyle behaviors, mediating biomarkers, and risk of microvascular complications among individuals with type 2 diabetes: A cohort study

Caring for Patients with Type II Diabetes Mellitus: A Nursing Case Report

Impact of health practice index and cardiovascular health metrics on incident cardiovascular disease according to glucose tolerance status

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