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Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses

Author

Listed:
  • Vanesa Bellou
  • Lazaros Belbasis
  • Ioanna Tzoulaki
  • Evangelos Evangelou

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.

Suggested Citation

  • Vanesa Bellou & Lazaros Belbasis & Ioanna Tzoulaki & Evangelos Evangelou, 2018. "Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-27, March.
  • Handle: RePEc:plo:pone00:0194127
    DOI: 10.1371/journal.pone.0194127
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    4. João Botelho & Paulo Mascarenhas & João Viana & Luís Proença & Marco Orlandi & Yago Leira & Leandro Chambrone & José João Mendes & Vanessa Machado, 2022. "An umbrella review of the evidence linking oral health and systemic noncommunicable diseases," Nature Communications, Nature, vol. 13(1), pages 1-11, December.
    5. David Rojas-Rueda & Emily Morales-Zamora & Wael Abdullah Alsufyani & Christopher H. Herbst & Salem M. AlBalawi & Reem Alsukait & Mashael Alomran, 2021. "Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses," IJERPH, MDPI, vol. 18(2), pages 1-38, January.
    6. Chau Minh Nguyen & Cornelia Melinda Adi Santoso & Duyen Thi Huong Vu & Gergő Szőllősi & Róbert Bata & Judit Zsuga & Attila Csaba Nagy, 2021. "Awareness Related to Cardiometabolic Diseases: A Cross-Sectional Study in Southern Vietnam," IJERPH, MDPI, vol. 18(19), pages 1-8, September.
    7. M. Monique McMillian & Roland J. Thorpe, 2021. "Relationships of Educational Attainment and Household Food Insecurity with Obesity: Findings from the 2007–2016 National Health and Nutrition Examination Survey," IJERPH, MDPI, vol. 18(15), pages 1-8, July.
    8. Sultan Ayoub Meo & Thamir Al-khlaiwi & Abdulelah Adnan Abukhalaf & Ali Abdullah Alomar & Omar Mohammed Alessa & Faris Jamal Almutairi & Majed Mohammed Alasbali, 2020. "The Nexus between Workplace Exposure for Wood, Welding, Motor Mechanic, and Oil Refinery Workers and the Prevalence of Prediabetes and Type 2 Diabetes Mellitus," IJERPH, MDPI, vol. 17(11), pages 1-10, June.
    9. Li, Junming & Wang, Sixian & Han, Xiulan & Zhang, Gehong & Zhao, Min & Ma, Ling, 2020. "Spatiotemporal trends and influence factors of global diabetes prevalence in recent years," Social Science & Medicine, Elsevier, vol. 256(C).
    10. Beverly W. X. Wong & Win Pa Pa Thu & Yiong Huak Chan & Michael S. Kramer & Susan Logan & Jane A. Cauley & Eu-Leong Yong, 2022. "The Associations between Upper and Lower Body Muscle Strength and Diabetes among Midlife Women," IJERPH, MDPI, vol. 19(20), pages 1-11, October.
    11. Annabelle Kuipers & Gitte C. Kloek & Sanne I. de Vries, 2021. "Understanding Vocational Students’ Motivation for Dietary and Physical Activity Behaviors," IJERPH, MDPI, vol. 18(4), pages 1-12, February.

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