Abstract：
BACKGROUND: Lifestyle intervention prevents or delays type 2 diabetes (T2D) in subjects at a high risk of T2D. However, it is not known whether genetic variants modify the effect on incident T2D during lifestyle intervention.
OBJECTIVE: To investigate whether a low or high genetic risk has effects on incident T2D in a group-based lifestyle intervention study.
METHODS: The T2D-GENE trial involved 973 men from the Metabolic Syndrome in Men (METSIM) cohort, aged 50-75 years, body mass index ≥25 kg/m2, fasting plasma glucose 5.6-6.9 mmol/l, and HbA1c <48 mmol/mol and either a low or high genetic risk score for T2D. There were two intervention groups, a low (n=315) and high genetic risk for T2D (n=313). They were provided with a 3-year group-based intervention with access to a web portal focused on healthy diet and physical activity. There were also corresponding population-based control groups at low (n=196), and high genetic risk for T2D (n=149) who had two laboratory visits (0 and 3 years) and general health advice as a part of their METSIM cohort protocol. The primary outcome was incident T2D, and a secondary outcome glycemia.
RESULTS: The intervention significantly lowered the risk of T2D among the participants with a high genetic risk for T2D (HR 0.30, 95% CI 0.16-0.56, p<0.001) whereas in the low genetic risk group the effect was not significant (HR 0.69, 95% CI 0.36-1.32, p=0.262). The intervention effect was not significantly different between the high and low genetic risk groups (p=0.135). The intervention significantly ameliorated the worsening of glycemia and decreased weight both in the low and high genetic risk groups.
CONCLUSIONS: Our results showed that individuals with a high genetic risk for T2D benefited from a low-cost group-based intervention focusing on healthy diet and physical activity. Therefore, all individuals at risk of T2D should be encouraged to make lifestyle changes regardless of genetic risk.
OBJECTIVE: To investigate whether a low or high genetic risk has effects on incident T2D in a group-based lifestyle intervention study.
METHODS: The T2D-GENE trial involved 973 men from the Metabolic Syndrome in Men (METSIM) cohort, aged 50-75 years, body mass index ≥25 kg/m2, fasting plasma glucose 5.6-6.9 mmol/l, and HbA1c <48 mmol/mol and either a low or high genetic risk score for T2D. There were two intervention groups, a low (n=315) and high genetic risk for T2D (n=313). They were provided with a 3-year group-based intervention with access to a web portal focused on healthy diet and physical activity. There were also corresponding population-based control groups at low (n=196), and high genetic risk for T2D (n=149) who had two laboratory visits (0 and 3 years) and general health advice as a part of their METSIM cohort protocol. The primary outcome was incident T2D, and a secondary outcome glycemia.
RESULTS: The intervention significantly lowered the risk of T2D among the participants with a high genetic risk for T2D (HR 0.30, 95% CI 0.16-0.56, p<0.001) whereas in the low genetic risk group the effect was not significant (HR 0.69, 95% CI 0.36-1.32, p=0.262). The intervention effect was not significantly different between the high and low genetic risk groups (p=0.135). The intervention significantly ameliorated the worsening of glycemia and decreased weight both in the low and high genetic risk groups.
CONCLUSIONS: Our results showed that individuals with a high genetic risk for T2D benefited from a low-cost group-based intervention focusing on healthy diet and physical activity. Therefore, all individuals at risk of T2D should be encouraged to make lifestyle changes regardless of genetic risk.
摘要：
背景：生活方式干预可预防或延迟2型糖尿病（T2D）高危受试者的T2D。然而,目前尚不清楚在生活方式干预期间,遗传变异是否改变了对T2D的影响.
目的：在一项基于群体的生活方式干预研究中，探讨低或高遗传风险对T2D事件的影响。
方法：T2D-GENE试验涉及男性代谢综合征（METSIM）队列中的973名男性，50-75岁,体重指数≥25kg/m2，空腹血糖5.6-6.9mmol/l，和HbA1c<48mmol/mol，T2D的低或高遗传风险评分。有两个干预组，T2D的遗传风险低（n=315）和高（n=313）。为他们提供了为期3年的基于小组的干预措施，可以访问专注于健康饮食和体育锻炼的门户网站。也有相应的基于人群的对照组在低（n=196），和T2D的高遗传风险（n=149），他们有两次实验室访问（0年和3年）和一般健康建议，作为其METSIM队列方案的一部分。主要结果是T2D事件，和次要结果血糖。
结果：干预措施显著降低了具有高T2D遗传风险的参与者的T2D风险（HR0.30，95％CI0.16-0.56，p<0.001），而在低遗传风险组中，效果不显著（HR0.69，95％CI0.36-1.32，p=0.262）。高、低遗传风险组干预效果差异无统计学意义(p=0.135)。干预措施显着改善了低遗传风险和高遗传风险组的血糖恶化和体重下降。
结论：我们的结果表明，具有高T2D遗传风险的个体受益于以健康饮食和体力活动为重点的低成本团体干预。因此,无论遗传风险如何,都应鼓励所有有T2D风险的个体改变生活方式.
目的：在一项基于群体的生活方式干预研究中，探讨低或高遗传风险对T2D事件的影响。
方法：T2D-GENE试验涉及男性代谢综合征（METSIM）队列中的973名男性，50-75岁,体重指数≥25kg/m2，空腹血糖5.6-6.9mmol/l，和HbA1c<48mmol/mol，T2D的低或高遗传风险评分。有两个干预组，T2D的遗传风险低（n=315）和高（n=313）。为他们提供了为期3年的基于小组的干预措施，可以访问专注于健康饮食和体育锻炼的门户网站。也有相应的基于人群的对照组在低（n=196），和T2D的高遗传风险（n=149），他们有两次实验室访问（0年和3年）和一般健康建议，作为其METSIM队列方案的一部分。主要结果是T2D事件，和次要结果血糖。
结果：干预措施显著降低了具有高T2D遗传风险的参与者的T2D风险（HR0.30，95％CI0.16-0.56，p<0.001），而在低遗传风险组中，效果不显著（HR0.69，95％CI0.36-1.32，p=0.262）。高、低遗传风险组干预效果差异无统计学意义(p=0.135)。干预措施显着改善了低遗传风险和高遗传风险组的血糖恶化和体重下降。
结论：我们的结果表明，具有高T2D遗传风险的个体受益于以健康饮食和体力活动为重点的低成本团体干预。因此,无论遗传风险如何,都应鼓励所有有T2D风险的个体改变生活方式.
