Cited by 714Diabetes, Cardiovascular Risks, and LipoproteinsAdipokines, Inflammation, and Metabolic DiseasesGenetic Associations and Epidemiology

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

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Bellou, Vanesa, Belbasis, Lazaros, Tzoulaki, Ioanna, Evangelou, Evangelos·2018·PLOS ONE

DOI 10.1371/journal.pone.0194127PMC PMC5860745

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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.

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Authors: Bellou, V., Belbasis, L., Tzoulaki, I., & Evangelou, E.
Affiliations: University of Ioannina (GR)
ORCID: Bellou, Vanesa
Belbasis, Lazaros
Tzoulaki, Ioanna
Evangelou, Evangelos
Venue: PLOS ONE
Publisher: Public Library of Science (PLoS)
Published: 2018-03-20
Volume: 13
Issue: 3
Pages: e0194127
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0194127
PMC: PMC5860745
OpenAlex: W2789317488
Cited by: 713
References: 136
Citations by year: 2026: 58 · 2025: 72 · 2024: 116 · 2023: 115 · 2022: 117 · 2021: 97 · 2020: 82 · 2019: 46 · 2018: 10
FWCI: 9.04
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: PLoS ONE (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Spiral (Imperial College London) (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
Keywords: type 2 diabetes, risk factors, non-genetic risk factors, adiposity, serum biomarkers, dietary habits, physical activity, sedentary behavior, alcohol consumption, smoking, air pollution, metabolic syndrome, gestational diabetes mellitus, preterm birth, educational attainment, conscientiousness, psychosocial factors, umbrella review of meta-analyses, Mendelian randomization
MeSH terms: Air Pollution, Diabetes Mellitus, Type 2, Diet, Humans, Life Style, Obesity, Risk Factors, Exercise

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

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