Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses.
Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses.
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DOI：
10.1371/journal.pone.0194127
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Evangelou E
中科院分区：
文献类型：
--
作者：
Bellou V;Belbasis L;Tzoulaki I;Evangelou E
2型糖尿病(T2 DM)是一种全球性流行病，与医疗支出增加和生活质量下降有关。已经提出了许多非遗传风险因素，但它们的总体流行病学可信度尚未得到评估。我们检索PubMed以获取T2 DM危险因素的所有荟萃分析和孟德尔随机研究。对于每个关联，我们估计了汇总效应的大小、其95%的可信度和预测区间以及I2度量。我们检查了小规模研究效应和过度显着性偏差的存在。我们通过一套预定义的标准来评估流行病学的可信度。我们收集了86篇符合条件的论文(142个协会)，涵盖了广泛的生物标记物、医疗条件以及饮食、生活方式、环境和心理社会因素。肥胖、低臀围、血清生物标志物(丙氨酸氨基转移酶、γ-谷氨酰转移酶、尿酸和C-反应蛋白水平升高，脂联素和维生素D水平下降)、不健康的饮食模式(增加加工肉类和含糖饮料的消费、减少全谷物、咖啡和血红素铁的摄入量，以及对健康饮食模式的低依从性)、低教育水平和责任心、体力活动减少、久坐时间和看电视的时间长、低酒精饮酒、吸烟、空气污染和一些医疗条件(高收缩血压、月经初潮晚期、糖尿病、代谢综合征、早产)为T2 DM风险增加提供了强有力的证据。健康的生活方式可以降低患2型糖尿病的风险。未来的随机临床试验应该侧重于确定有效的策略，以改变有害的日常习惯和易患的饮食模式。
Type 2 diabetes mellitus (T2DM) is a global epidemic associated with increased health expenditure, and low quality of life. Many non-genetic risk factors have been suggested, but their overall epidemiological credibility has not been assessed. We searched PubMed to capture all meta-analyses and Mendelian randomization studies for risk factors of T2DM. For each association, we estimated the summary effect size, its 95% confidence and prediction interval, and the I2 metric. We examined the presence of small-study effects and excess significance bias. We assessed the epidemiological credibility through a set of predefined criteria. We captured 86 eligible papers (142 associations) covering a wide range of biomarkers, medical conditions, and dietary, lifestyle, environmental and psychosocial factors. Adiposity, low hip circumference, serum biomarkers (increased level of alanine aminotransferase, gamma-glutamyl transferase, uric acid and C-reactive protein, and decreased level of adiponectin and vitamin D), an unhealthy dietary pattern (increased consumption of processed meat and sugar-sweetened beverages, decreased intake of whole grains, coffee and heme iron, and low adherence to a healthy dietary pattern), low level of education and conscientiousness, decreased physical activity, high sedentary time and duration of television watching, low alcohol drinking, smoking, air pollution, and some medical conditions (high systolic blood pressure, late menarche age, gestational diabetes, metabolic syndrome, preterm birth) presented robust evidence for increased risk of T2DM. A healthy lifestyle pattern could lead to decreased risk for T2DM. Future randomized clinical trials should focus on identifying efficient strategies to modify harmful daily habits and predisposing dietary patterns.
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影响因子：
16.2
作者：
Cappuccio FP;D'Elia L;Strazzullo P;Miller MA
通讯作者：
Miller MA
影响因子：
7.1
作者：
Afshin, Ashkan;Micha, Renata;Mozaffarian, Dariush
通讯作者：
Mozaffarian, Dariush
影响因子：
13.6
作者：
Buijsse, Brian;Boeing, Heiner;Kaaks, Rudolf
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Kaaks, Rudolf
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影响因子：
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作者：
Corbin LJ;Richmond RC;Wade KH;Burgess S;Bowden J;Smith GD;Timpson NJ
通讯作者：
Timpson NJ
影响因子：
9.3
作者：
Belbasis L;Savvidou MD;Kanu C;Evangelou E;Tzoulaki I
通讯作者：
Tzoulaki I