Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid
Abstract Background Whether and to what extent serum uric acid (SUA) mediates the association between combined lifestyle behaviors and type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to investigate the role of SUA in the relationship between healthy lifestyle scores (HLS) and the in...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Nutrition & Metabolism |
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| Online Access: | https://doi.org/10.1186/s12986-023-00763-y |
| _version_ | 1797637043413581824 |
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| author | Xinyue He Wei Shao Senhai Yu Jiazhou Yu Changzhen Huang Haiqing Ren Chengguo Liu Yuying Xu Yimin Zhu |
| author_facet | Xinyue He Wei Shao Senhai Yu Jiazhou Yu Changzhen Huang Haiqing Ren Chengguo Liu Yuying Xu Yimin Zhu |
| author_sort | Xinyue He |
| collection | DOAJ |
| description | Abstract Background Whether and to what extent serum uric acid (SUA) mediates the association between combined lifestyle behaviors and type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to investigate the role of SUA in the relationship between healthy lifestyle scores (HLS) and the incidence of T2DM. Methods This prospective study used data from Zhejiang Metabolic Syndrome cohort. A HLS (5-point scale including healthy waist circumference (WC), never smoking, high physical activity, healthy diet and moderate alcohol intake) was estimated in 13,919 participants, who had SUA at baseline examination in 2009–2014, and were followed-up to 2021–2022 to ascertain incident of T2DM. Cox proportional hazards models and mediation analysis were used to examine the associations between HLS, SUA and T2DM. Results We included 13,919 participants aged 18 years or older without diabetes at baseline (mean age 54.6 [SD 13.9] years, 58.7% female). During a median follow-up of 9.94 years, 645 cases of T2DM occurred. Compared with participants with a poor HLS, those with 4–5 low-risk lifestyle factors showed a 60% reduction in the risk of developing T2DM (adjusted HR, 0.40; 95% CI: 0.28–0.57). Further, the population-attributable risk percent (95% CI) of T2DM for poor adherence to the overall healthy lifestyle (< 4 low-risk factors) was 43.24% (30.02%, 56.46%). The HLS was inversely associated with SUA level. With per score increased in HLS, the beta (95% CI) of SUA (log transformed) was − 0.03 (− 0.03, − 0.02), and the odds ratio (95% CI) of hyperuricemia was 0.82 (0.77, 0.86). The relationship between the HLS and risk of T2DM was mediated by SUA with a 13.06% mediation effect. There was no significant combined effect of HLS and SUA on risk of T2DM (P = 0.097). Conclusions The relationship between overall healthy lifestyle behaviors and T2DM was reconfirmed and the association appeared to be mediated by SUA. The mediation effect of baseline SUA was more pronounced among women who were below 60 years old. |
| first_indexed | 2024-03-11T12:43:44Z |
| format | Article |
| id | doaj.art-61b4daf89a5f405a9a154acb79231a2b |
| institution | Directory Open Access Journal |
| issn | 1743-7075 |
| language | English |
| last_indexed | 2024-03-11T12:43:44Z |
| publishDate | 2023-11-01 |
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| series | Nutrition & Metabolism |
| spelling | doaj.art-61b4daf89a5f405a9a154acb79231a2b2023-11-05T12:09:35ZengBMCNutrition & Metabolism1743-70752023-11-0120111110.1186/s12986-023-00763-yHealthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acidXinyue He0Wei Shao1Senhai Yu2Jiazhou Yu3Changzhen Huang4Haiqing Ren5Chengguo Liu6Yuying Xu7Yimin Zhu8Department of Epidemiology and Biostatistics and Department of Respiratory Diseases of Sir Run Run Show Hospital, Affiliated to School of Medicine, Zhejiang UniversityZhejiang Putuo HospitalXiaoshan District Yiqiao Community Health Service CenterJockey Club School of Public Health and Primary Care, The Chinese University of Hong KongDongyang Traditional Chinese Medicine HospitalDongyang Traditional Chinese Medicine HospitalZhejiang Putuo HospitalDepartment of Epidemiology and Biostatistics and Teaching Experiment Center for Public Health, Zhejiang UniversityDepartment of Epidemiology and Biostatistics and Department of Respiratory Diseases of Sir Run Run Show Hospital, Affiliated to School of Medicine, Zhejiang UniversityAbstract Background Whether and to what extent serum uric acid (SUA) mediates the association between combined lifestyle behaviors and type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to investigate the role of SUA in the relationship between healthy lifestyle scores (HLS) and the incidence of T2DM. Methods This prospective study used data from Zhejiang Metabolic Syndrome cohort. A HLS (5-point scale including healthy waist circumference (WC), never smoking, high physical activity, healthy diet and moderate alcohol intake) was estimated in 13,919 participants, who had SUA at baseline examination in 2009–2014, and were followed-up to 2021–2022 to ascertain incident of T2DM. Cox proportional hazards models and mediation analysis were used to examine the associations between HLS, SUA and T2DM. Results We included 13,919 participants aged 18 years or older without diabetes at baseline (mean age 54.6 [SD 13.9] years, 58.7% female). During a median follow-up of 9.94 years, 645 cases of T2DM occurred. Compared with participants with a poor HLS, those with 4–5 low-risk lifestyle factors showed a 60% reduction in the risk of developing T2DM (adjusted HR, 0.40; 95% CI: 0.28–0.57). Further, the population-attributable risk percent (95% CI) of T2DM for poor adherence to the overall healthy lifestyle (< 4 low-risk factors) was 43.24% (30.02%, 56.46%). The HLS was inversely associated with SUA level. With per score increased in HLS, the beta (95% CI) of SUA (log transformed) was − 0.03 (− 0.03, − 0.02), and the odds ratio (95% CI) of hyperuricemia was 0.82 (0.77, 0.86). The relationship between the HLS and risk of T2DM was mediated by SUA with a 13.06% mediation effect. There was no significant combined effect of HLS and SUA on risk of T2DM (P = 0.097). Conclusions The relationship between overall healthy lifestyle behaviors and T2DM was reconfirmed and the association appeared to be mediated by SUA. The mediation effect of baseline SUA was more pronounced among women who were below 60 years old.https://doi.org/10.1186/s12986-023-00763-yCohort studyHealthy lifestyle scoreUric acidType 2 diabetes mellitus |
| spellingShingle | Xinyue He Wei Shao Senhai Yu Jiazhou Yu Changzhen Huang Haiqing Ren Chengguo Liu Yuying Xu Yimin Zhu Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid Nutrition & Metabolism Cohort study Healthy lifestyle score Uric acid Type 2 diabetes mellitus |
| title | Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid |
| title_full | Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid |
| title_fullStr | Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid |
| title_full_unstemmed | Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid |
| title_short | Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid |
| title_sort | healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid |
| topic | Cohort study Healthy lifestyle score Uric acid Type 2 diabetes mellitus |
| url | https://doi.org/10.1186/s12986-023-00763-y |
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