{"title":"遗传风险和生活方式因素在糖尿病发展为糖尿病肾病中的作用：一项前瞻性队列研究","authors":"Yujiao Wang, Chunyang Li, Nongbu Cili, Jing Chen, Huazhen Yang, Ping Fu, Xiaoxi Zeng","doi":"10.1111/1753-0407.70141","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>Diabetes is a global public health crisis, especially when it is accompanied by microvascular complications such as diabetic kidney disease (DKD). The purpose of this study was to explore the relationship between the combined lifestyle factors of diabetes patients and their joint effects with genetic risk and the risk of DKD.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>We included individuals diagnosed with diabetes at baseline from UK Biobank. Their lifestyle information was collected through a baseline questionnaire. Favorable lifestyle scores were constructed based on 5 common lifestyle factors and categorized into three levels. Genetic susceptibility to CKD was estimated by polygenic risk scores and further categorized into high, and low genetic risk categories. Cox proportional hazards regression model was used to estimate the hazard ratios (HR) and 95% confidence interval (CI) for their associations.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>By the end of follow-up, 1335 of 11 981 diabetes patients progressed to diabetes nephropathy. The COX regression results indicate that BMI ≥ 25 mg/m<sup>2</sup> and current or past smoking were risk factors for DKD, while alcohol consumption and moderate to high-intensity pysical exercise were protective factors. High genetic risk is significantly associated with increased risk of DKD (HR1.29, 95% CI 1.13–1.47, <i>p</i> < 0.001), while a favorable lifestyle had a protective effect (HR0.47, 95% CI 0.37–0.59, <i>p</i> < 0.001). Interaction analysis shows that there was neither additive nor multiplicative interaction between genetic risk and lifestyle.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Lifestyle factors and genetics are independently associated with susceptibility to incident DKD. A healthy lifestyle may attenuate elevated DKD risks due to genetic vulnerability.</p>\n </section>\n </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 9","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70141","citationCount":"0","resultStr":"{\"title\":\"The Contribution of Genetic Risk and Lifestyle Factors in the Progression of Diabetes to Diabetic Kidney Disease: A Prospective Cohort Study\",\"authors\":\"Yujiao Wang, Chunyang Li, Nongbu Cili, Jing Chen, Huazhen Yang, Ping Fu, Xiaoxi Zeng\",\"doi\":\"10.1111/1753-0407.70141\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>Diabetes is a global public health crisis, especially when it is accompanied by microvascular complications such as diabetic kidney disease (DKD). 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The COX regression results indicate that BMI ≥ 25 mg/m<sup>2</sup> and current or past smoking were risk factors for DKD, while alcohol consumption and moderate to high-intensity pysical exercise were protective factors. High genetic risk is significantly associated with increased risk of DKD (HR1.29, 95% CI 1.13–1.47, <i>p</i> < 0.001), while a favorable lifestyle had a protective effect (HR0.47, 95% CI 0.37–0.59, <i>p</i> < 0.001). Interaction analysis shows that there was neither additive nor multiplicative interaction between genetic risk and lifestyle.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Lifestyle factors and genetics are independently associated with susceptibility to incident DKD. 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引用次数: 0
摘要
目的：糖尿病是一个全球性的公共卫生危机，特别是当它伴有微血管并发症，如糖尿病肾病（DKD）时。本研究旨在探讨糖尿病患者的综合生活方式因素及其与遗传风险和DKD风险的共同作用之间的关系。材料和方法：我们纳入了来自UK Biobank的基线诊断为糖尿病的个体。他们的生活方式信息是通过基线问卷收集的。根据5个常见的生活方式因素构建良好的生活方式评分，分为3个等级。通过多基因风险评分来评估CKD的遗传易感性，并进一步分为高遗传风险和低遗传风险类别。采用Cox比例风险回归模型估计其相关性的风险比（HR）和95%置信区间（CI）。结果：随访结束时，11,981例糖尿病患者中有1335例进展为糖尿病肾病。COX回归结果显示，BMI≥25 mg/m2和当前或过去吸烟是DKD的危险因素，而饮酒和中高强度体育锻炼是DKD的保护因素。高遗传风险与DKD风险增加显著相关（HR1.29, 95% CI 1.13-1.47, p）。结论：生活方式因素和遗传与DKD易感性独立相关。健康的生活方式可以降低由于遗传易感性而增加的DKD风险。
The Contribution of Genetic Risk and Lifestyle Factors in the Progression of Diabetes to Diabetic Kidney Disease: A Prospective Cohort Study
Aims
Diabetes is a global public health crisis, especially when it is accompanied by microvascular complications such as diabetic kidney disease (DKD). The purpose of this study was to explore the relationship between the combined lifestyle factors of diabetes patients and their joint effects with genetic risk and the risk of DKD.
Materials and Methods
We included individuals diagnosed with diabetes at baseline from UK Biobank. Their lifestyle information was collected through a baseline questionnaire. Favorable lifestyle scores were constructed based on 5 common lifestyle factors and categorized into three levels. Genetic susceptibility to CKD was estimated by polygenic risk scores and further categorized into high, and low genetic risk categories. Cox proportional hazards regression model was used to estimate the hazard ratios (HR) and 95% confidence interval (CI) for their associations.
Results
By the end of follow-up, 1335 of 11 981 diabetes patients progressed to diabetes nephropathy. The COX regression results indicate that BMI ≥ 25 mg/m2 and current or past smoking were risk factors for DKD, while alcohol consumption and moderate to high-intensity pysical exercise were protective factors. High genetic risk is significantly associated with increased risk of DKD (HR1.29, 95% CI 1.13–1.47, p < 0.001), while a favorable lifestyle had a protective effect (HR0.47, 95% CI 0.37–0.59, p < 0.001). Interaction analysis shows that there was neither additive nor multiplicative interaction between genetic risk and lifestyle.
Conclusions
Lifestyle factors and genetics are independently associated with susceptibility to incident DKD. A healthy lifestyle may attenuate elevated DKD risks due to genetic vulnerability.
期刊介绍：
Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation.
The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.
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