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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Additional file 2 of Non-communicable diseases research output in the Eastern Mediterranean region: an overview of systematic reviews
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Additional file 9 of Physical activity and the risk of developing 8 age-related diseases: epidemiological and Mendelian randomization studies
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Additional file 1 of Exploring the potential of mobile health interventions to address behavioural risk factors for the prevention of non-communicable diseases in Asian populations: a qualitative study
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Additional file 4 of Physical activity and the risk of developing 8 age-related diseases: epidemiological and Mendelian randomization studies
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Additional file 8 of Physical activity and the risk of developing 8 age-related diseases: epidemiological and Mendelian randomization studies
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Additional file 3 of Trait impulsivity is associated with an increased risk of type 2 diabetes incidence in adults over 8 years of follow-up: results from the NutriNet-Santé cohort
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Additional file 2 of Physical activity and the risk of developing 8 age-related diseases: epidemiological and Mendelian randomization studies
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Additional file 2 of Defining type 2 diabetes polygenic risk scores through colocalization and network-based clustering of metabolic trait genetic associations
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Additional file 3 of Validity of observational evidence on putative risk and protective factors: appraisal of 3744 meta-analyses on 57 topics
Janiaud, P., Agarwal, A., Tzoulaki, I., Theodoratou, E., Tsilidis, K. K., Evangelou, E., & Ioannidis, J. P. A. (2021) · Figshare · doi:10.6084/m9.figshare.14913270
Self-citation
Additional file 4 of Validity of observational evidence on putative risk and protective factors: appraisal of 3744 meta-analyses on 57 topics
Janiaud, P., Agarwal, A., Tzoulaki, I., Theodoratou, E., Tsilidis, K. K., Evangelou, E., & Ioannidis, J. P. A. (2021) · Figshare · doi:10.6084/m9.figshare.14913273
Self-citation
Additional file 7 of Validity of observational evidence on putative risk and protective factors: appraisal of 3744 meta-analyses on 57 topics
Janiaud, P., Agarwal, A., Tzoulaki, I., Theodoratou, E., Tsilidis, K. K., Evangelou, E., & Ioannidis, J. P. A. (2021) · Figshare · doi:10.6084/m9.figshare.14913282
Self-citation
Additional file 3 of Defining type 2 diabetes polygenic risk scores through colocalization and network-based clustering of metabolic trait genetic associations
Ghatan, S., van Rooij, J., van Hoek, M., Boer, C. G., Felix, J. F., Kavousi, M., Jaddoe, V. W., Sijbrands, E. J. G., Medina-Gomez, C., Rivadeneira, F., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26665996
Additional file 1 of Intersectional analysis of social disparities in type 2 diabetes risk among adults in Germany: results from a nationwide population-based survey
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Additional file 3 of Exploring the potential of mobile health interventions to address behavioural risk factors for the prevention of non-communicable diseases in Asian populations: a qualitative study
Mair, J. L., Castro, Ó., Salamanca-Sanabria, A., Frese, B. F., von Wangenheim, F., Tai, E. S., Kowatsch, T., & Müller‐Riemenschneider, F. (2023) · Figshare · doi:10.6084/m9.figshare.22688901
Additional file 2 of Mendelian randomization indicates that atopic dermatitis contributes to the occurrence of diabetes
Lu, F., Wu, B., & Wang, Y. (2024) · Figshare · doi:10.6084/m9.figshare.26597384
Additional file 2 of Trait impulsivity is associated with an increased risk of type 2 diabetes incidence in adults over 8 years of follow-up: results from the NutriNet-Santé cohort
Martínez, C. G., Paolassini-Guesnier, P., Fezeu, L., Srour, B., Herçberg, S., Touvier, M., Babió, N., Salas-Salvadó, J., & Péneau, S. (2024) · Figshare · doi:10.6084/m9.figshare.26761725
Additional file 6 of Validity of observational evidence on putative risk and protective factors: appraisal of 3744 meta-analyses on 57 topics
Janiaud, P., Agarwal, A., Tzoulaki, I., Theodoratou, E., Tsilidis, K. K., Evangelou, E., & Ioannidis, J. P. A. (2021) · Figshare · doi:10.6084/m9.figshare.14913279
Self-citation
Additional file 3 of Physical activity and the risk of developing 8 age-related diseases: epidemiological and Mendelian randomization studies
Zhao, J., Ke, Z., Huang, R., Wen, X., Liu, W., Wang, S., Zhang, X., Zhuang, X., Pan, L., & Liao, L. (2024) · Figshare · doi:10.6084/m9.figshare.27059042
Additional file 8 of Validity of observational evidence on putative risk and protective factors: appraisal of 3744 meta-analyses on 57 topics
Janiaud, P., Agarwal, A., Tzoulaki, I., Theodoratou, E., Tsilidis, K. K., Evangelou, E., & Ioannidis, J. P. A. (2021) · Figshare · doi:10.6084/m9.figshare.14913285
Self-citation
Additional file 3 of Mendelian randomization indicates that atopic dermatitis contributes to the occurrence of diabetes
Lu, F., Wu, B., & Wang, Y. (2024) · Figshare · doi:10.6084/m9.figshare.26597387
Additional file 2 of Validity of observational evidence on putative risk and protective factors: appraisal of 3744 meta-analyses on 57 topics
Janiaud, P., Agarwal, A., Tzoulaki, I., Theodoratou, E., Tsilidis, K. K., Evangelou, E., & Ioannidis, J. P. A. (2021) · Figshare · doi:10.6084/m9.figshare.14913267
Self-citation
Additional file 2 of Intersectional analysis of social disparities in type 2 diabetes risk among adults in Germany: results from a nationwide population-based survey
Färber, F., Alonso-Pérez, E., Heidemann, C., Du, Y., Stadler, G., Gellert, P., & O’Sullivan, J. L. (2024) · Figshare · doi:10.6084/m9.figshare.25237431
Additional file 5 of Physical activity and the risk of developing 8 age-related diseases: epidemiological and Mendelian randomization studies
Zhao, J., Ke, Z., Huang, R., Wen, X., Liu, W., Wang, S., Zhang, X., Zhuang, X., Pan, L., & Liao, L. (2024) · Figshare · doi:10.6084/m9.figshare.27059048
Additional file 9 of Validity of observational evidence on putative risk and protective factors: appraisal of 3744 meta-analyses on 57 topics
Janiaud, P., Agarwal, A., Tzoulaki, I., Theodoratou, E., Tsilidis, K. K., Evangelou, E., & Ioannidis, J. P. A. (2021) · Figshare · doi:10.6084/m9.figshare.14913288
Self-citation
Additional file 7 of Physical activity and the risk of developing 8 age-related diseases: epidemiological and Mendelian randomization studies
Zhao, J., Ke, Z., Huang, R., Wen, X., Liu, W., Wang, S., Zhang, X., Zhuang, X., Pan, L., & Liao, L. (2024) · Figshare · doi:10.6084/m9.figshare.27059054
Additional file 1 of Validity of observational evidence on putative risk and protective factors: appraisal of 3744 meta-analyses on 57 topics
Janiaud, P., Agarwal, A., Tzoulaki, I., Theodoratou, E., Tsilidis, K. K., Evangelou, E., & Ioannidis, J. P. A. (2021) · Figshare · doi:10.6084/m9.figshare.14913264
Self-citation
Additional file 1 of Trait impulsivity is associated with an increased risk of type 2 diabetes incidence in adults over 8 years of follow-up: results from the NutriNet-Santé cohort
Martínez, C. G., Paolassini-Guesnier, P., Fezeu, L., Srour, B., Herçberg, S., Touvier, M., Babió, N., Salas-Salvadó, J., & Péneau, S. (2024) · Figshare · doi:10.6084/m9.figshare.26761641
Additional file 6 of Physical activity and the risk of developing 8 age-related diseases: epidemiological and Mendelian randomization studies
Zhao, J., Ke, Z., Huang, R., Wen, X., Liu, W., Wang, S., Zhang, X., Zhuang, X., Pan, L., & Liao, L. (2024) · Figshare · doi:10.6084/m9.figshare.27059051
Additional file 1 of Defining type 2 diabetes polygenic risk scores through colocalization and network-based clustering of metabolic trait genetic associations
Ghatan, S., van Rooij, J., van Hoek, M., Boer, C. G., Felix, J. F., Kavousi, M., Jaddoe, V. W., Sijbrands, E. J. G., Medina‐Gómez, C., Rivadeneira, F., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26665990
Additional file 1 of Physical activity and the risk of developing 8 age-related diseases: epidemiological and Mendelian randomization studies
Zhao, J., Ke, Z., Huang, R., Wen, X., Liu, W., Wang, S., Zhang, X., Zhuang, X., Pan, L., & Liao, L. (2024) · Figshare · doi:10.6084/m9.figshare.27059036
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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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