European Journal of Epidemiology

, Volume 25, Issue 2, pp 115–124 | Cite as

The relative importance of modifiable potential risk factors of type 2 diabetes: a meta-analysis of two cohorts

  • Maarit A. Laaksonen
  • Paul Knekt
  • Harri Rissanen
  • Tommi Härkänen
  • Esa Virtala
  • Jukka Marniemi
  • Arpo Aromaa
  • Markku Heliövaara
  • Antti Reunanen
DIABETES MELLITUS

Abstract

Lifestyle factors predict type 2 diabetes occurrence, but their effect in high- and low-risk populations is poorly known. This study determines the prediction of low-risk lifestyle on type 2 diabetes in those with and without metabolic syndrome in a pooled sample of two representative Finnish cohorts, collected in 1978–1980 and 2000–2001. Altogether 8,627 individuals, aged 40–79 years, and free of diabetes and cardiovascular disease at baseline were included in this study. A low-risk lifestyle was defined based on body mass index, exercise, alcohol consumption, smoking, and serum vitamin D concentration. The metabolic syndrome was defined according to the International Diabetes Federation including obesity, blood pressure, serum HDL cholesterol, serum triglycerides, and fasting glucose. During a 10-year follow-up, altogether 226 type 2 diabetes cases occurred. Overweight was the strongest predictor of type 2 diabetes (population attributable fraction (PAF) = 77%, 95% confidence interval (CI): 53, 88%). Together with lack of exercise, unsatisfactory alcohol consumption, smoking, and low vitamin D concentration it explained 82% of the cases. Altogether 62% (CI: 47, 73%) of the cases were attributable to the metabolic syndrome and 92% (CI: 67, 98%) to the most unfavourable combination of its components. The metabolic syndrome did not modify the prediction of lifestyle factors but persons with normal blood pressure benefited more from positive changes in exercise, alcohol consumption, and smoking than those with elevated blood pressure (P for interaction = 0.01). In conclusion, modification of lifestyle factors apparently reduces type 2 diabetes risk, especially in persons with normal blood pressure.

Keywords

Type 2 diabetes Low-risk lifestyle Metabolic syndrome Cohort studies Pooling Population attributable fraction (PAF) 

Abbreviations

BMI

Body mass index

CI

95% Confidence interval

HDL

High-density lipoprotein

Health 2000

Health 2000 Survey

IDF

International Diabetes Federation

MFH

Mini-Finland Health Survey

PAF

Population attributable fraction

RR

Relative risk

WHO

World Health Organisation

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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Maarit A. Laaksonen
    • 1
  • Paul Knekt
    • 1
  • Harri Rissanen
    • 1
  • Tommi Härkänen
    • 1
  • Esa Virtala
    • 1
  • Jukka Marniemi
    • 2
  • Arpo Aromaa
    • 1
  • Markku Heliövaara
    • 1
  • Antti Reunanen
    • 1
  1. 1.National Institute for Health and WelfareHelsinkiFinland
  2. 2.National Institute for Health and WelfareTurkuFinland

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