In a September study published in the European Journal of Preventive Cardiology, Netherlands scientists found that middle-aged adults with good cardiovascular health have a reduced risk of developing the chronic condition.
To do so, the group looked at individuals with and without a genetic predisposition to Type 2 diabetes, including 5,993 individuals.
Using data from the prospective population-based Rotterdam Study, the researchers included mostly women participants who were 69 years old on average.
A cardiovascular health score was calculated with the participant’s body mass index, blood pressure, total cholesterol, smoking status, diet and physical activity and further categorized at the baseline.
A genetic risk score was also created using 403 independent genetic variants associated with the disease, classifying participants as having a low, intermediate or high risk.
Higher scores indicated better cardiovascular health and then the participants were divided into three groups indicating their remaining lifetime risk of developing Type 2 diabetes.
For the “ideal” group the remaining lifetime risk was 22.6%; it was 28.3% for intermediate and 32.6% for poor cardiovascular health.
Accounting for genetic risk, the lifetime risk was still the lowest for the ideal cardiovascular health score in the lowest, middle and highest tertiles when compared with poor and intermediate cardiovascular health scores.
At index age 55 for those in the high genetic risk group, the remaining lifetime risk was 23.5% for ideal, 33.7% for intermediate and 38.7% for poor cardiovascular health groups, respectively.
“The lifetime risk for [Type 2 diabetes] was still the lowest for ideal [cardiovascular health] in the lowest [genetic risk score] tertile, in the second [genetic risk score] tertile, and in the highest [genetic risk score] tertile when compared with the remaining lifetime risk of [Type 2 diabetes] for poor and intermediate [cardiovascular health],” the authors wrote.
Using behavioral and biological cardiovascular health scores, the group assessed the lifetime risk, finding it was lower in the ideal cardiovascular health categories than in the poor and intermediate ones.
Results from individual cardiovascular health components suggested that behavioral factors – especially body mass index – have the most influence.
The group noted that while the American Heart Association considers body mass index a behavior, that is “controversial because it may suggest that obesity is a choice” while “others suggest obesity should be considered a health metric.”
The pathogenesis of Type 2 diabetes is driven by genetic and non-genetic factors like obesity, an unhealthy diet and physical activity, warranting multilevel intervention measures to improve Type 2 diabetes prevention.
Nearly 870 individuals developed Type 2 diabetes during follow-ups.
Noting the study’s limitations, the authors had gathered individual cardiovascular health metrics at baseline around 20 to 27 years earlier, which they note could have led to “participants’ misclassification.”
In addition, in analyses, estimations were based on relatively small sample sizes and the study mainly included individuals of European ancestry.
According to the U.S. Centers for Disease Control and Prevention, more than 34 million people in the U.S. live with diabetes and 90% to 95% of them have Type 2 diabetes.