Healthy lifestyle tied to reduced risk of PAD in genetically susceptible type 2 diabetes patients: Study

The research from the UK Biobank, spanning over 13.5 years, revealed that adhering to a favourable lifestyle characterized by regular exercise, non-smoking, moderate alcohol intake, a high-quality diet, sufficient sleep, and optimal waist-to-hip ratio led to a remarkable reduction in the risk of peripheral artery disease in T2D patients. A favourable lifestyle also partly mitigated the genetic risk of PAD.

The study was conducted by Gang Liu, Huazhong University of Science and Technology, Wuhan, China, and colleagues to evaluate the association between modifiable lifestyle factors and peripheral artery disease among individuals with type 2 diabetes.

The researchers included 14,543 individuals with type 2 diabetes from the UK Biobank. A weighted healthy lifestyle score was defined using adequate sleep duration, optimal waist-to-hip ratio, moderate alcohol consumption, regular physical activity, high-quality diet and nonsmoking. They were categorized into unfavourable, intermediate, and favourable lifestyles.

A genetic risk score (GRS) was 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.

Based on the study, the researchers reported the following findings:

• 628 incident cases of PAD were documented after a median of 13.5 years of follow-up.
• A linear inverse association between the weighted lifestyle score and PAD was observed, with a hazard ratio (HR) of 0.27 for favourable compared with unfavourable lifestyle.
• An estimated 58.3% 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 per SD increment: 1.13).
• A favourable lifestyle partially mitigated 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% of the association between weighted lifestyle score and PAD.

"A favourable lifestyle was associated with lower PAD risk among patients with T2D, independent of genetic predisposition to PAD," the researchers concluded.

Reference:

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: 10.2337/dc23-1503. Epub ahead of print. PMID: 38181303.