Comprehensive risk profiles of family history and lifestyle and metabolic risk factors in relation to diabetes: A prospective cohort study

Abstract

Background Family history of diabetes, unhealthy lifestyles, and metabolic disorders are individually associated with higher risk of diabetes, but how different combinations of the three risk categories are associated with incident diabetes remains unclear. We aimed to estimate the associations of comprehensive risk profiles of family history and lifestyle and metabolic risk factors with diabetes risk. Methods This study included 5290 participants without diabetes at baseline with a mean follow‐up of 4.4 years. Five unhealthy lifestyles and five metabolic disorders were each allocated a score, resulting in an aggregated lifestyle and metabolic risk score ranging from 0 to 5. Eight risk profiles were constructed from combinations of three risk categories: family history of diabetes (yes, no), lifestyle risk (high, low), and metabolic risk (high, low). Results Compared with the profile without any risk category, other profiles exhibited incrementally higher risks of diabetes with increasing numbers of categories: the hazard ratio (HR, 95% confidence interval [CI]) for diabetes ranged from 1.34 (1.01–1.79) to 2.33 (1.60–3.39) for profiles with one risk category, ranged from 2.42 (1.45–4.04) to 4.18 (2.42–7.21) for profiles with two risk categories, and was 4.59 (2.85–7.39) for the profile with three risk categories. The associations between the numbers of risk categories and diabetes risk were more prominent in women ( p interaction = .025) and slightly more prominent in adults <55 years ( p interaction = .052). Conclusions This study delineated associations between comprehensive risk profiles with diabetes risk, with stronger associations observed in women and slightly stronger associations in adults younger than 55 years.

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“…Hypertriglyceridemia is becoming the most common form of hyperlipidemia, and increases the risks of acute pancreatitis, atherosclerotic cardiovascular disease (ASCVD), non-alcoholic fatty liver (NAFLD), and diabetes (Simha, 2020;Hernandez et al, 2021). The ensuing 60 years of research has indicated that there was a close correlation between hypertriglyceridemia and Type 2 diabetes mellitus (T2DM), which hypertriglyceridemia often existed years before the prediabetic and diabetic state (Berkowitz, 1966;Lorenzo et al, 2013;Li et al, 2020;Ye et al, 2022).…”