Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses
Bellou V, Belbasis L, Tzoulaki I, Evangelou E
PloS one · 470 citations
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Not stated
Who paid for it
- Funding
- Independent funding
Based on full-text disclosure statement.
Publication
- Published
- 2018-03-20 · PLoS One · vol. 13 · issue 3 · p. e0194127
- Publisher
- Public Library of Science
- Cited
- 743 citations · more than 100% of similar papers · 53.3× the field average
- Impact
- Top 10% most cited in its field
- References
- 137 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Nutritional Studies and Diet · Nutrition, Genetics, and Disease · Genetic Associations and Epidemiology
- Keywords
- Medicine, Mendelian randomization, Type 2 diabetes, Adiponectin, Environmental health, Internal medicine, Gestational diabetes, Diabetes mellitus, Physiology, Obesity, Insulin resistance, Pregnancy, Endocrinology, Biology
- MeSH
- humans, diabetes mellitus, type 2, obesity, exercise, diet, risk factors, life style, air pollution
4 authors
From GR, GB
- Vanesa BellouUniversity of Ioannina
- Lazaros BelbasisUniversity of Ioannina
- Ioanna TzoulakiUniversity of Ioannina; Imperial College London
- Evangelos Evangelou · correspondingUniversity of Ioannina; Imperial College London
Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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