The cumulative risk factors of early life such as low birth weight, lack of breastfeeding and maternal smoking are associated independently and additively with an increased risk of type 2 diabetes (T2D) to adulthood, regardless of genetic risk or adult lifestyle published in healthy behaviors BMC medication.
The researchers conducted a prospective cohort study to assess the relationship between the cumulative modifiable risk factors of early life and T2D development in adulthood on the basis of genetic predisposition or healthy life behavior later. Participants of the British Biobank were aged 40 to 69 at registration.
Three early factors, including low birth weight (<2.5 kg), maternal smoking during pregnancy and the lack of breastfeeding, were used to calculate a risk score (ERS). The genetic predisposition has been quantified using a standard polygenic (T2D-PRS) risk score, and adult lifestyle has been assessed using a modifiable healthy lifestyle score (MHS) based on the "Life's Essential 8" measures of the American Heart Association (diet, physical activity, exposure to nicotine and sleep).
“”
These results highlight the importance of effective intervention strategies at the start of life for T2D prevention through life.
Among this large British biobank cohort of 148,621 participants (average age, 55.4 years), 7408 had the T2D either at the start, or during a median follow -up of 12.5 years. The T2D prevalence was 4.98%and more in men (6.11%) than women (4.25%).
The researchers observed a dose-response association between the cumulative ERs and the T2D risk. Compared to individuals without early risk factors, those with 1, 2 or 3 factors had a risk of 16% (risk ratio (HR), 1.16), 26% (HR, 1.26) and 93% (HR, 1.93) higher risk of T2D, respectively. The highest T2D-PRS printile participants presented a risk of 3.28 times higher than those of the lowest printile, and the highest articular risk was observed in people with an ERS of 3 and high T2D-PRS (HR, 6.67).
An adult health lifestyle, measured by the MHS, has been associated with a significantly lower T2D risk. People with healthy and unhealthy lifestyle scores presented a reduced risk by 53% (HR, 0.47). Although the ERS is associated with a higher T2D risk at all levels of lifestyle, researchers have observed no significant interaction between ERs and MHS. The highest combined risk has occurred in individuals with an ERS of 3 and an unhealthy lifestyle (HR, 4.99).
The sensitivity analyzes have confirmed these associations through the definitions of sex, BMI, genetic ancestry and alternative weight. All combinations of early risk factors, except nobreast-feeding Only an increased T2D risk was associated.
The limits of the study include a lack of generalization of results, selection biases and the evaluation of only 3 early risk factors.
The authors of the study concluded: “These results underline the importance of effective intervention strategies at the start of life for the prevention of T2D through life.