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A new & # 39; Global Atlas & # 39; study published in Diabetologia identifies insomnia as a risk factor for an increased risk of developing type 2 diabetes (T2D) for the first time. The study identified 34 risk factors believed to increase (19) or decrease (15) risk, and another 21 “suggestive” risk factors for which the evidence was not quite as strong.
The study by Associate Professor Susanna Larsson and Shuai Yuan of Karolinska Institutet, Stockholm, Sweden, used a technique called "Mendelian Randomization" (MR), which uses genetic variation as a natural experiment to examine the causal relationships between potentially mutable risk factors and health outcomes in observational data. MR is less likely to be affected by confusing or reverse causes than observational studies.
To identify possible risk factors for T2D, the authors reviewed the meta-analyzes and review articles in the PubMed database and found 1,360 relevant articles. They found a total of 97 risk factors that could be examined with the MR method. For the study population, they used summary data from the DIAbetes Genetics Replication And Meta-Analysis consortium (74,124 cases of type 2 diabetes and 824,006 controls of European descent). The team then checked with the FinnGen consortium (11,006 type 2 diabetes cases and 82,655 European ancestry controls) whether these potential causal links could be replicated in a separate independent population.
They found evidence of causal relationships between 34 exposures (19 risk factors and 15 protective factors) and T2D. Insomnia has been identified as a novel risk factor, with people with insomnia 17% more likely to develop T2D than people without.
The other 18 risk factors for T2D were depression, systolic blood pressure, smoking cessation, lifelong smoking, coffee (caffeine) consumption, blood plasma levels of the amino acids isoleucine, valine and leucine, liver enzyme alanine aminotransferase (a sign of liver function), body mass index (BMI) in children and adults Adult age, body fat percentage, visceral (internal) fat mass, resting heart rate and blood plasma levels of four fatty acids.
The 15 exposures associated with a decreased risk of type 2 diabetes were plasma alanine (an amino acid), high density lipoprotein (good cholesterol) and total cholesterol, age at onset of puberty in women (menarche), testosterone levels, Sex hormone binding globulin levels (adjusted to the BMI), birth weight, height in adulthood, lean body mass (for women), four plasma fatty acids, circulating vitamin D and years of training.
After adjusting for BMI in adulthood, 8 risk factors remained statistically significantly associated with T2D risk, suggesting that they are independent of body weight (see Figure 2, full publication). Insomnia remained one of these factors, but the increased risk for people with insomnia compared to people without insomnia decreased from 17% to 7% after adjusting the BMI, indicating that part of the effect of insomnia on T2D risk was due to the BMI is taught. Systolic blood pressure, lifelong smoking and liver enzyme levels remained risk factors (positively associated with T2D). The increase in total cholesterol, good cholesterol, testosterone and sex hormone levels remained as a protective factor after the adjustment (inversely associated with T2D).
The other 21 "suggestive" causal factors for type 2 diabetes (for which the evidence was weaker than the other factors listed above) included alcohol consumption, skipping breakfast, daytime naps, short sleep, sodium (salt) Urine levels and certain amino acids and inflammatory factors.
The authors conclude: "Our study confirmed several pre-established risk factors and identified new potential risk factors for type 2 diabetes using the latest summary-level data. The results should influence health policy for primary prevention of type 2 diabetes. Prevention strategies should be constructed from different perspectives, such as reducing obesity and smoking rates and levels, and improving mental health, sleep quality, educational levels and birth weight. "
Childhood BMI and the variability of HDL-C can increase the risk of diabetes later in life
Shuai Yuan et al. An Atlas of Risk Factors for Type 2 Diabetes: A Wide Angle Mendelian Randomization Study, Diabetologia (2020). DOI: 10.1007 / s00125-020-05253-x
A new study (2020, September 8th) identified insomnia as a new risk factor for type 2 diabetes.
accessed on September 9, 2020
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