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Genetic Risk, Adherence to Healthy Lifestyle, and Type 2 Diabetes: The Dongfeng-Tongji Cohort Study

37 Pages Posted: 17 May 2019

See all articles by Xu Han

Xu Han

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Yue Wei

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Hua Hu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Jing Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Zhaoyang Li

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Fei Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Tengfei Long

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Jing Yuan

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Ping Yao

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Sheng Wei

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Youjie Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Xiaomin Zhang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Huan Guo

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Handong Yang

Hubei University of Medicine

Tangchun Wu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

Meian He

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health; Ministry of Education & Ministry of Environmental Protection, Key Laboratory of Environmental and Health; Huazhong University of Science and Technology (Formerly Tongi Medical University) - State Key Laboratory of Environmental Health (Incubating)

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Abstract

Background: Genetic and lifestyle factors both contribute to diabetes development, but whether healthy lifestyle could reduce diabetes risk among individuals with different genetic profile is unknown.

Methods: A prospective cohort study with 19,005 participants from the Dongfeng-Tongji Cohort were performed. Adherence to a healthy lifestyle was determined on the basis of six factors: non-smoker, non-drinker, healthy diet, body mass index of 18.5 to 23.9 kg/m2, waist circumference <85 cm for men and <80 cm for women, and higher level of physical exercise. Hazard ratios (HRs) of combined healthy lifestyle factors on incident diabetes were estimated using Cox proportional hazard regression. A polygenic risk score of 88 single nucleotide polymorphisms previously associated with diabetes was constructed to test for an association with diabetes risk among 7,344 individuals, estimated using Logistic regression.

Findings: Of 19,005 individuals, 10,438 (54.9%) were female, and the mean (SD) age was 63.2 (7.7) years. During a median follow-up of 4.6 years 1,555 incident diabetes (8.2%) were ascertained. The risk of diabetes escalated with the increment of genetic risk score. Per SD of simple and weighted GRS increase was respectively significantly associated with 1.42 and 1.45 fold higher diabetes risk. Compared with poor lifestyle (0 to 2 healthy lifestyle factors), individuals with intermediate (3 or 4 healthy lifestyle factors) or ideal lifestyle (5 or 6 healthy lifestyle factors) had 23% (HR, 0.77; 95% CI, 0.69-0.87) and 46% (HR, 0.54; 95% CI, 0.45-0.65) decreased risk of incident diabetes, respectively. The association of lifestyle factors with diabetes risk was independent of genetic risk stratums. Among individuals at the high genetic risk group, intermediate and ideal lifestyle was associated with 29% lower (OR, 0.71; 95% CI: 0.58-0.86) and 49% lower (OR, 0.51; 95% CI: 0.38-0.69) risk of diabetes.

Interpretation: Genetic and lifestyle factors were independently associated with diabetes risk. A healthy lifestyle could lower diabetes risk across different genetic risk categories, emphasizing the benefit of entire populations adhering to a healthy lifestyle, independent of genetic risk.

Funding Statement: This work was supported by the grant from the National Natural Science Foundation (grant NSFC-81522040, 81473051, and 81230069); the Program for HUST Academic Frontier Youth Team; National Key R&D Program of China (2017YFC0907501); the 111 Project (No. B12004); the Program for Changjiang Scholars; Innovative Research Team in University of Ministry of Education of China (No. IRT1246); China Postdoctoral Science Funding (2018M630869); and China Medical Board (No. 12-113).

Declaration of Interests: No potential conflicts of interest relevant to this article were reported.

Ethics Approval Statement: The present study has been approved by the Ethics and Human Subject Committee of the School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, and Dongfeng General Hospital, the Dongfeng Motor Corporation (DMC). All study participants provided written informed consents.

Keywords: lifestyle factors, genetic risk score, type 2 diabetes, interaction

Suggested Citation

Han, Xu and Wei, Yue and Hu, Hua and Wang, Jing and Li, Zhaoyang and Wang, Fei and Long, Tengfei and Yuan, Jing and Yao, Ping and Wei, Sheng and Wang, Youjie and Zhang, Xiaomin and Guo, Huan and Yang, Handong and Wu, Tangchun and He, Meian, Genetic Risk, Adherence to Healthy Lifestyle, and Type 2 Diabetes: The Dongfeng-Tongji Cohort Study (May 14, 2019). Available at SSRN: https://ssrn.com/abstract=3388822

Xu Han

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Yue Wei

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Hua Hu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Jing Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Zhaoyang Li

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Fei Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Tengfei Long

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Jing Yuan

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health ( email )

1037 Luoyu Rd
Wuhan
China

Ping Yao

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Sheng Wei

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Youjie Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Xiaomin Zhang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

1037 Luoyu Rd
Wuhan
China

Huan Guo

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health

13 Hangkong Rd
Wuhan, 430030
China

Handong Yang

Hubei University of Medicine

Shiyan, Hubei
China

Tangchun Wu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health ( email )

1037 Luoyu Rd
Wuhan
China

Meian He (Contact Author)

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Occupational and Environmental Health ( email )

13 Hangkong Rd
Wuhan, 430030
China

Ministry of Education & Ministry of Environmental Protection, Key Laboratory of Environmental and Health ( email )

Wuhan
China

Huazhong University of Science and Technology (Formerly Tongi Medical University) - State Key Laboratory of Environmental Health (Incubating) ( email )

Wuhan, 430030
China

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