TY - JOUR
T1 - Population attributable fractions of the main type 2 diabetes mellitus risk factors in women: Findings from the French E3N cohort
T2 - Findings from the French E3N cohort
AU - Rajaobelina, Kalina
AU - Dow, Courtney
AU - Romana Mancini, Francesca
AU - Dartois, Laureen
AU - Boutron-Ruault, Marie Christine
AU - Balkau, Beverley
AU - Bonnet, Fabrice
AU - Fagherazzi, Guy
N1 - Funding Information:
The authors are grateful to all participants for providing the data used in the E3N cohort Study. The E3N study is being conducted with the financial support of the Mutuelle G?n?rale de l'Education Nationale, European Community, French League Against Cancer, Gustave Roussy, and the French Institute of Health and Medical Research. The present study was also supported by the French Research Agency (Agence Nationale de la Recherche) via an ?Investissement d'Avenir? grant (ANR-10-COHO-0006) that supports the E4N study. This study is conducted in the framework of ?Nutriperso? project supported by Paris-Saclay University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Funding Information:
The authors are grateful to all participants for providing the data used in the E3N cohort Study. The E3N study is being conducted with the financial support of the Mutuelle Générale de l’Education Nationale, European Community, French League Against Cancer, Gustave Roussy, and the French Institute of Health and Medical Research. The present study was also supported by the French Research Agency (Agence Natio-nale de la Recherche) via an “Investissement d’Avenir” grant (ANR-10-COHO-0006) that supports the E4N study. This study is conducted in the framework of “Nutriperso” project supported by Paris-Saclay University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2018 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd
PY - 2019/3
Y1 - 2019/3
N2 - Background: Although many type 2 diabetes mellitus (T2DM) risk factors have been identified, little is known regarding their contributions to the diabetes burden at the population level. Methods: The study included 72 655 French women from the Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective cohort followed between 1993 and 2011. Cox multivariable models including the main T2DM risk factors (metabolic, dietary, clinical, socioeconomic and hormonal) and a healthy lifestyle index combining five characteristics (smoking, body mass index [BMI], alcohol consumption, fruit and vegetable consumption, and physical activity) were used to estimate hazard ratios and population attributable fractions (PAFs) for T2DM. Results: In multivariate models, factors with the strongest effect on T2DM risk were, in decreasing order, BMI ≥ 30 kg/m 2 (PAF = 43%; 95% confidence interval [CI] 37–47), high adherence to a Western dietary pattern (PAF = 30%; 95% CI 20–40), hypertension (PAF = 26%; 95% CI 20–32), an acidogenic diet (PAF = 24%; 95% CI 16–32), a family history of diabetes (PAF = 20%; 95% CI 17–22), and, with a negative correlation, moderate alcohol consumption (PAF–19%; 95% CI –34, −4). The PAF for an unhealthy lifestyle was 57% (95% CI 50–63). Conclusions: We have been able to sort out and quantify the effect of various dietary and biological T2DM risk factors simultaneously in a single population, and to highlight the importance of a healthy lifestyle for primary prevention: more than half the T2DM cases could have been prevented through a healthier lifestyle.
AB - Background: Although many type 2 diabetes mellitus (T2DM) risk factors have been identified, little is known regarding their contributions to the diabetes burden at the population level. Methods: The study included 72 655 French women from the Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective cohort followed between 1993 and 2011. Cox multivariable models including the main T2DM risk factors (metabolic, dietary, clinical, socioeconomic and hormonal) and a healthy lifestyle index combining five characteristics (smoking, body mass index [BMI], alcohol consumption, fruit and vegetable consumption, and physical activity) were used to estimate hazard ratios and population attributable fractions (PAFs) for T2DM. Results: In multivariate models, factors with the strongest effect on T2DM risk were, in decreasing order, BMI ≥ 30 kg/m 2 (PAF = 43%; 95% confidence interval [CI] 37–47), high adherence to a Western dietary pattern (PAF = 30%; 95% CI 20–40), hypertension (PAF = 26%; 95% CI 20–32), an acidogenic diet (PAF = 24%; 95% CI 16–32), a family history of diabetes (PAF = 20%; 95% CI 17–22), and, with a negative correlation, moderate alcohol consumption (PAF–19%; 95% CI –34, −4). The PAF for an unhealthy lifestyle was 57% (95% CI 50–63). Conclusions: We have been able to sort out and quantify the effect of various dietary and biological T2DM risk factors simultaneously in a single population, and to highlight the importance of a healthy lifestyle for primary prevention: more than half the T2DM cases could have been prevented through a healthier lifestyle.
KW - lifestyle
KW - nutrition
KW - population attributable fraction
KW - type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=85053670371&partnerID=8YFLogxK
U2 - 10.1111/1753-0407.12839
DO - 10.1111/1753-0407.12839
M3 - Article
C2 - 30098121
AN - SCOPUS:85053670371
SN - 1753-0393
VL - 11
SP - 242
EP - 253
JO - Journal of Diabetes
JF - Journal of Diabetes
IS - 3
ER -