Relationship of microvascular complications and healthy lifestyle with all-cause and cardiovascular mortality in women compared with men with type 2 diabetes

Liu, Yu-Jie1; Li, Fu-Rong2; Han, Wen-Wen1; Liu, Yan1; Liu, Yu1; Wang, Jia-Min1; Miao, Meng-Yuan1; Lyu, Jie-Qiong1; Wan, Zhong-Xiao1; Qin, Li-Qiang1,3; Chen, Guo-Chong1,3

2024-04-01

10.1016/j.clnu.2024.03.005

CLINICAL NUTRITION   影响因子和分区

0261-5614

1532-1983

Background: Sex differences exist in the prevalence of microvascular disease (MVD) and healthy-lifestyle adherence. Whether MVD and healthy lifestyles are associated with mortality risk similarly for women and men who have type 2 diabetes mellitus (T2DM) remains unknown. Methods: The present study included 9992 women and 15,860 men with T2DM from the UK Biobank. MVDs included retinopathy, peripheral neuropathy, and chronic kidney disease. Healthy lifestyle factors consisted of ideal BMI, nonsmoking, healthy diet, regular exercise, and appropriate sleep duration. Sex-specific hazard ratios (HRs) of mortality associated with the MVDs or healthy lifestyles were calculated and women-to-men ratio of HRs (RHR) were further estimated, after multivariable adjustment for potential confounders. Results: During a median of 12.7 years of follow-up, 4346 (1202 in women) all-cause and 1207 (254 in women) CVD deaths were recorded. The adjusted HRs (95% CI) of all-cause mortality for 1 additional increment of the MVDs were 1.71 (1.55, 1.88) for women and 1.48 (1.39, 1.57) for men, with an RHR of 1.16 (1.03, 1.30). The corresponding RHR was 1.36 (1.09, 1.69) for cardiovascular mortality. Adhering to a healthy lifestyle (>= 4 vs. <= 1 lifestyle factor) was associated with an approximately 60%-70% lower risk of all-cause and cardiovascular mortality without sex differences (P-interaction >0.70). Furthermore, as compared with having no MVD and an unfavorable lifestyle, having >= 2 MVDs but a favorable lifestyle was not associated with a higher risk of all-cause mortality either in women (HR = 0.88; 95% CI: 0.49, 1.60) or in men (HR = 0.95; 95% CI: 0.64, 1.40), similarly when considering cardiovascular mortality. Conclusions: In T2DM, while MVDs are more strongly associated with mortality risk in women than in men, adhering to a favorable lifestyle is associated with a substantially lower risk of mortality and may eliminate the detrimental impact of MVDs in both sexes. (c) 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Cardiovascular disease Lifestyle Microvascular complications Mortality Type 2 diabetes mellitus

SCI

英语

其他

Gusu Leading Talent Plan for Scientific and Technological Innovation and Entrepreneurship[ZXL2023345] ; Shenzhen Medical Academy of Research and Translation[C2302001] ; Shenzhen Science and Technology Innovation Committee[ZDSYS20200810171403013]

Nutrition & Dietetics

Nutrition & Dietetics

WOS:001225587900001

CHURCHILL LIVINGSTONE

CLINICAL MEDICINE

Web of Science

1.Soochow Univ, Sch Publ Hlth, MOE Key Lab Geriatr Dis & Immunol, Dept Nutr & Food Hyg,Suzhou Med Coll, Suzhou, Peoples R China
2.Southern Univ Sci & Technol, Sch Publ Hlth & Emergency Management, Shenzhen, Peoples R China
3.Soochow Univ, Sch Publ Hlth, Dept Nutr & Food Hyg, Suzhou Med Coll, 199 Renai Rd, Suzhou 215123, Peoples R China

Liu, Yu-Jie,Li, Fu-Rong,Han, Wen-Wen,et al. Relationship of microvascular complications and healthy lifestyle with all-cause and cardiovascular mortality in women compared with men with type 2 diabetes[J]. CLINICAL NUTRITION,2024,43(4).

Liu, Yu-Jie.,Li, Fu-Rong.,Han, Wen-Wen.,Liu, Yan.,Liu, Yu.,...&Chen, Guo-Chong.(2024).Relationship of microvascular complications and healthy lifestyle with all-cause and cardiovascular mortality in women compared with men with type 2 diabetes.CLINICAL NUTRITION,43(4).

Liu, Yu-Jie,et al."Relationship of microvascular complications and healthy lifestyle with all-cause and cardiovascular mortality in women compared with men with type 2 diabetes".CLINICAL NUTRITION 43.4(2024).