Impact of lifestyle on diabetic nephropathy in aged 18-64 years: A population-based cross-sectional analysis from NHANES 2007-2018.

Background: The relationship between lifestyle and overall health has garnered significant attention. This study aimed to evaluate the association between lifestyle factors and diabetic nephropathy (DN) in adults aged 18-64 years.

Materials and methods: We conducted a cross-sectional study involving 2,389 participants from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). The use of the Healthy Eating Index (HEI), Metabolic Equivalent of Task (MET), sleeping duration, smoking, and drinking status as indicators to assess lifestyle. Logistic regression analyses and restricted cubic splines were used to analyze the results. A subgroup analysis was performed to identify any variations.

Results: Logistic regression analysis indicates that poor HEI and sleep duration but not physical activity are associated with an increased risk of DN. Subgroup analyses revealed significant interactions between HEI and age, blood pressure, HbA1c, and lipid control; MET interacted with blood pressure and HbA1c control; Sleeping duration interacted with age, smoking, blood pressure, HbA1c, and lipid control; Smoking interacted with age, blood pressure control, and lipid control; Drinking interacted with blood pressure control. Moreover, restricted cubic splines indicated that with increasing HEI, the prevalence of DN tended to decrease. However, the associations between the other two lifestyle factors (MET level and sleeping duration) and DN were all U-shaped.

Conclusions: Lifestyle factors are closely associated with diabetic nephropathy. Both unhealthy eating habits and inadequate or excessive sleeping duration and physical activity contribute to an increased risk of diabetic nephropathy, whereas no statistically significant association is observed in smoking and drinking.