Journal Article

Association of ideal cardiovascular health metrics and incident type 2 diabetes mellitus among an urban population of Iran: One decade follow up in the Tehran Lipid and Glucose Study

Azizi, Fereidoun, Moslehi, Nazanin, Hosseinpour‐Niazi, Somaye, Masrouri, Soroush, Hadaegh, Farzad, Asgari, Samaneh

2022

Overview

Aims/Introduction To evaluate the association between ideal cardiovascular health metrics (ICVHM) and incident type 2 diabetes mellitus among Iranian men and women. Materials and Methods The study population included 7,488 Iranian adults aged ≥20 years (4,236 women) free from diabetes at baseline. The ICVHM was defined according to the American Heart Association's 2020 impact goals. The multivariable Cox proportional hazards regression analysis was used to calculate the hazard ratios (HRs) for ICVHM both as continuous and categorical variables. Results Over the median of 9.1 years of follow‐up, we identified 922 new cases of type 2 diabetes mellitus (526 women). Body mass index <30 kg/m2, untreated systolic/diastolic blood pressure <120/80 mmHg in both sexes, and physical activity ≥1,500 MET min/week (only among men) were significantly associated with a lower risk of type 2 diabetes mellitus. Each additional unit in the ICVHM was associated with a 21 and 15% lower risk of type 2 diabetes mellitus in men and women, respectively (P‐values <0.05). Compared with participants having poor cardiovascular health, the HR for type 2 diabetes mellitus risk was 0.69 (95% confidence interval [CI] 0.56–0.85) and 0.35 (95% CI 0.21–0.59) for men with intermediate and ideal CVHM, respectively. The corresponding values for women were 0.79 (95% CI 0.65–0.97) and 0.30 (95% CI 0.15–0.60), respectively. In a subpopulation with nutritional data (n = 2,236), ideal and intermediate nutritional status was associated with 83 and 77% lower risk of type 2 diabetes mellitus only among women (P‐values <0.05). Conclusion We found a strong inverse association between having higher global ICVHM with incident type 2 diabetes mellitus; which is mainly attributable to normal blood pressure, normal body weight, and intensive physical activity (only for men). Type 2 diabetes mellitus persists as a world epidemic, which is associated with increased risk of mortality and morbidity, particularly from cardiovascular diseases. Adherence to the American Heart Association cardiovascular health metrics, including body mass index, smoking status, physical activity, diet, total cholesterol, fasting plasma glucose, and blood pressure, is associated with a lower risk of cardiovascular disease and all‐cause mortality. In the current study, we examined the impact of sex on the association between ideal cardiovascular health metrics and the risk of type 2 diabetes mellitus. We found a strong inverse association between having higher global ideal cardiovascular health metrics with incident type 2 diabetes mellitus; the issue is mainly attributable to normal blood pressure, normal bodyweight and intensive physical activity (only for men).

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: American Heart Association / Blood pressure / Body mass index / Body weight / Cholesterol / Cohort analysis / Diabetes / Diabetes mellitus (non-insulin dependent) / Education / Fasting / Glucose / High density lipoprotein / Ideal cardiovascular health metrics / Laboratories / Mortality / Nutrition research / Nutritional status / Original / Physical activity / Plasma / Population / Population studies / Triglycerides / Type 2 diabetes mellitus / Variables / Womens health