TY - JOUR
T1 - Joint impact of modifiable lifestyle behaviors on glycemic control and insulin resistance in patients with type 2 diabetes
T2 - the Fukuoka Diabetes Registry
AU - Ohkuma, Toshiaki
AU - Iwase, Masanori
AU - Fujii, Hiroki
AU - Ide, Hitoshi
AU - Kaizu, Shinako
AU - Jodai, Tamaki
AU - Kikuchi, Yohei
AU - Idewaki, Yasuhiro
AU - Sumi, Akiko
AU - Nakamura, Udai
AU - Kitazono, Takanari
N1 - Publisher Copyright:
© 2017, The Japan Diabetes Society.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Aims: Little is known about the combined effects of unhealthy lifestyle behaviors on glycemia. The objective of this study was to examine the association between combined modifiable lifestyle and glycemic control, as well as markers of insulin resistance and secretion. Patients and methods: In total, 4,870 patients with type 2 diabetes were sorted by lifestyle scores. Scores were determined by summing the number of unhealthy lifestyle factors that showed a significant association with hemoglobin A1c (HbA1c) (current smoking, decreased dietary fiber intake, eating quickly, inadequate sleep duration, and obesity). The associations between lifestyle score and hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA2-IR), and β-cell function (HOMA2-%B) were cross-sectionally analyzed. Results: HbA1c increased progressively with increases in lifestyle score (p for trend <0.001). Mean HbA1c was 0.48% (95% confidence intervals 0.34–0.63) higher in patients with scores of four to five than in those with zero scores. HOMA2-IR and high-sensitivity C-reactive protein also revealed a similar tendency, but adiponectin showed an inverse association. However, these graded tendencies were not observed for HOMA2-%B. Additionally, lower HOMA2-%B levels enhanced the effects of lifestyle score on glycemia. Increases in HbA1c per point in the lifestyle score in patients with the lowest and highest quartiles of HOMA2-%B were 0.25% (0.18–0.32) and 0.10% (0.06–0.15), respectively (p for interaction <0.001). Conclusions: Accumulation of unhealthy lifestyle factors was dose-dependently associated with poor glycemic control, which may be modified by insulin secretory capacity.
AB - Aims: Little is known about the combined effects of unhealthy lifestyle behaviors on glycemia. The objective of this study was to examine the association between combined modifiable lifestyle and glycemic control, as well as markers of insulin resistance and secretion. Patients and methods: In total, 4,870 patients with type 2 diabetes were sorted by lifestyle scores. Scores were determined by summing the number of unhealthy lifestyle factors that showed a significant association with hemoglobin A1c (HbA1c) (current smoking, decreased dietary fiber intake, eating quickly, inadequate sleep duration, and obesity). The associations between lifestyle score and hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA2-IR), and β-cell function (HOMA2-%B) were cross-sectionally analyzed. Results: HbA1c increased progressively with increases in lifestyle score (p for trend <0.001). Mean HbA1c was 0.48% (95% confidence intervals 0.34–0.63) higher in patients with scores of four to five than in those with zero scores. HOMA2-IR and high-sensitivity C-reactive protein also revealed a similar tendency, but adiponectin showed an inverse association. However, these graded tendencies were not observed for HOMA2-%B. Additionally, lower HOMA2-%B levels enhanced the effects of lifestyle score on glycemia. Increases in HbA1c per point in the lifestyle score in patients with the lowest and highest quartiles of HOMA2-%B were 0.25% (0.18–0.32) and 0.10% (0.06–0.15), respectively (p for interaction <0.001). Conclusions: Accumulation of unhealthy lifestyle factors was dose-dependently associated with poor glycemic control, which may be modified by insulin secretory capacity.
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U2 - 10.1007/s13340-017-0310-6
DO - 10.1007/s13340-017-0310-6
M3 - Article
AN - SCOPUS:85027069415
SN - 2190-1678
VL - 8
SP - 296
EP - 305
JO - Diabetology International
JF - Diabetology International
IS - 3
ER -
