Modifiable lifestyle factors, genetic risk, and incident peripheral artery disease among individuals with type 2 diabetes

A paper published in the January edition of Diabetes Care prospectively evaluated the association between modifiable lifestyle factors and peripheral artery disease (PAD) among individuals with type 2 diabetes (T2D).14,543 individuals with T2D from the UK Biobank were included in the research. Researchers defined a weighted healthy lifestyle score using non-smoking, regular physical activity, high-quality diet, moderate alcohol consumption, optimal waist-to-hip ratio, and adequate sleep duration, and categorised into unfavourable, intermediate, and favourable lifestyles. A genetic risk score (GRS) was also created using 19 single nucleotide polymorphisms previously found to be associated with PAD. The association between lifestyle score and PAD was modelled, overall and stratified by PAD genetic susceptibility.
After a median 13.5 years of follow-up, 628 incident cases of PAD were documented. A linear inverse association between the weighted lifestyle score and PAD was observed, with a hazard ratio (HR) (95% CI) of 0.27 (0.19, 0.38) for favourable compared with unfavourable lifestyle. The study authors estimate that 58.3% (45.0%, 69.1%) of PAD in this population could be potentially avoidable if all participants attained a favourable lifestyle. Moreover, the PAD GRS was associated with increased PAD risk (HR [95% CI] per SD increment: 1.13 [1.03, 1.23]). A favourable lifestyle was able to partially mitigate the excess risk of PAD associated with higher GRS, albeit as a nonsignificant interaction. Several biomarkers in the lipid metabolism, hepatic/renal function, and systemic inflammation pathways collectively explained 13.3% (8.5%, 20.1%) of the association between weighted lifestyle score and PAD.A favourable lifestyle was associated with lower risk of PAD among individuals with T2D, independent of genetic predisposition to PAD.
Source: Zhu K, Qian F, Lu Q, Li R, Qiu Z, Li L, Li R, Yu H, Deng Y, Yang K, Pan A, Liu G. Modifiable Lifestyle Factors, Genetic Risk, and Incident Peripheral Artery Disease Among Individuals With Type 2 Diabetes: A Prospective Study. Diabetes Care. 2024 Jan 5:dc231503. doi.org/10.2337/dc23-1503.