Genetic risk of type 2 diabetes modifies the association between lifestyle and glycemic health at 5 years postpartum among high-risk women

IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Sim Tieu, Saila Koivusalo, Jari Lahti, Elina Engberg, Hannele Laivuori, Emilia Huvinen
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Abstract

Introduction Lifestyle interventions are effective in preventing type 2 diabetes, but genetic background may influence the individual response. In the Finnish gestational diabetes prevention study, RADIEL, lifestyle intervention during pregnancy and first postpartum year was effective in preventing gestational diabetes (GDM) and postpartum glycemic abnormalities only among women at highest genetic risk of type 2 diabetes. This study aimed to assess whether still 5 years postpartum the genetic risk modifies the association between lifestyle and glycemic health. Research design and methods The RADIEL study (randomized controlled trial) aimed to prevent GDM with a lifestyle intervention among high-risk women (body mass index ≥30 kg/m2 and/or prior GDM). The follow-up study 5 years postpartum included anthropometric measurements, laboratory assessments, device-measured physical activity (PA), and questionnaires. A Healthy Lifestyle Score (HLS) indicated adherence to lifestyle goals (PA, diet, smoking) and a polygenic risk score (PRS) based on 50 type 2 diabetes risk alleles depicted the genetic risk. Results Altogether 314 women provided genetic and glycemic data 5 years postpartum. The PRS for type 2 diabetes was not associated with glycemic abnormalities, nor was HLS in the total study sample. There was, however, an interaction between HLS and type 2 diabetes PRS on glycemic abnormalities (p=0.03). When assessing the association between HLS and glycemic abnormalities in PRS tertiles, HLS was associated with reduced risk of glycemic abnormalities only among women at the highest genetic risk (p=0.008). Conclusions These results extend our previous findings from pregnancy and first postpartum year demonstrating that still at 5 years postpartum, healthy lifestyle is associated with a lower risk of prediabetes/diabetes only among women at the highest genetic risk of type 2 diabetes. Data are available on reasonable request. Present informed consents do not allow archiving clinical or register data in open repositories. Data described in the manuscript, code book, and analytic code will be made available on reasonable request and requests are subject to further review by the national register authority and by the ethical committees.
2 型糖尿病的遗传风险会改变高危妇女产后 5 年的生活方式与血糖健康之间的关系
导言:生活方式干预能有效预防 2 型糖尿病,但遗传背景可能会影响个体反应。在芬兰妊娠糖尿病预防研究 RADIEL 中,只有在 2 型糖尿病遗传风险最高的妇女中,孕期和产后第一年的生活方式干预才能有效预防妊娠糖尿病(GDM)和产后血糖异常。本研究旨在评估遗传风险是否会在产后 5 年内改变生活方式与血糖健康之间的关系。研究设计和方法 RADIEL 研究(随机对照试验)旨在通过对高风险妇女(体重指数≥30 kg/m2 和/或曾患过 GDM)进行生活方式干预来预防 GDM。产后 5 年的随访研究包括人体测量、实验室评估、设备测量的体力活动(PA)和问卷调查。健康生活方式评分(HLS)显示了对生活方式目标(PA、饮食、吸烟)的坚持情况,多基因风险评分(PRS)基于 50 个 2 型糖尿病风险等位基因,描述了遗传风险。结果 共有 314 名妇女提供了产后 5 年的遗传和血糖数据。在所有研究样本中,2 型糖尿病的 PRS 与血糖异常无关,HLS 也与血糖异常无关。但是,HLS 与 2 型糖尿病 PRS 之间存在血糖异常的交互作用(p=0.03)。在评估 HLS 与 PRS tertiles 中血糖异常之间的关系时,只有在遗传风险最高的女性中,HLS 才与血糖异常风险的降低有关(p=0.008)。结论 这些结果扩展了我们之前在妊娠期和产后第一年的研究结果,表明在产后 5 年,健康的生活方式仅与 2 型糖尿病遗传风险最高的妇女患糖尿病前期/糖尿病的风险降低有关。如有合理要求,可提供相关数据。目前的知情同意书不允许将临床或登记数据存档到开放资料库中。手稿、代码集和分析代码中描述的数据将在合理要求下提供,但要求需经过国家登记机构和伦理委员会的进一步审查。
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来源期刊
BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
9.30
自引率
2.40%
发文量
123
审稿时长
18 weeks
期刊介绍: BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.
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