Genetic risk, a healthy lifestyle, and type 2 diabetes: the Dongfeng-Tongji cohort study.

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To examine whether healthy lifestyle could reduce diabetes risk among individuals with different genetic profiles.A prospective cohort study with a median follow-up of 4.6 years from the Dongfeng-Tongji cohort was performed.19,005 individuals without diabetes at baseline participated in the study.A healthy lifestyle was determined based on six factors: non-smoker, non-drinker, healthy diet, BMI of 18.5 to 23.9 kg/m2, waist circumference <85 cm for men and <80 cm for women, and higher level of physical activity. Associations of combined lifestyle factors and incident diabetes were estimated using Cox proportional hazard regression. A polygenic risk score of 88 SNPs previously associated with diabetes was constructed to test for association with diabetes risk among 7,344 individuals, using Logistic regression.1,555 incident diabetes were ascertained. Per SD increment of simple and weighted GRS was associated with 1.39 and 1.34 fold higher diabetes risk respectively. Compared with poor lifestyle, intermediate and ideal lifestyle reduced 23% and 46% risk of incident diabetes respectively. Association of lifestyle with diabetes risk was independent of genetic risk. Even among individuals with high genetic risk, intermediate and ideal lifestyle was separately associated with 29% and 49% lower risk of diabetes.Genetic and combined 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.

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