Adherence to a healthy lifestyle, genetic susceptibility to abdominal obesity, cardiometabolic risk markers, and risk of coronary heart disease

Mengyao Wang; Shiu Lun Au Yeung; Shan Luo; Haeyoon Jang; Hin Sheung Ho; Stephen J Sharp; Katrien Wijndaele; Soren Brage; Nicholas J Wareham; Youngwon Kim

doi:10.1016/j.ajcnut.2023.08.002

Adherence to a healthy lifestyle, genetic susceptibility to abdominal obesity, cardiometabolic risk markers, and risk of coronary heart disease

Am J Clin Nutr. 2023 Nov;118(5):911-920. doi: 10.1016/j.ajcnut.2023.08.002. Epub 2023 Sep 26.

Authors

Affiliations

¹ School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong SAR, China.
² MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, United Kingdom.
³ School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong SAR, China; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, United Kingdom. Electronic address: youngwon.kim@hku.hk.

PMID: 37923500
DOI: 10.1016/j.ajcnut.2023.08.002

Abstract

Background: Little is known about whether the association between genetic susceptibility to high waist-to-hip ratio (WHR), a measure of abdominal obesity, and incident coronary heart disease (CHD) is modified by adherence to a healthy lifestyle.

Objectives: To explore the interplay of genetic susceptibility to high WHR and adherence to a healthy lifestyle on incident CHD.

Methods: This study included 282,316 white British individuals from the UK Biobank study. Genetic risk for high WHR was estimated in the form of weighted polygenic risk scores (PRSs), calculated based on 156 single-nucleotide polymorphisms. Lifestyle scores were calculated based on 5 healthy lifestyle factors: regular physical activity, no current smoking, a healthy diet, <3 times/wk of alcohol consumption and 7-9 h/d of sleep. Incident CHD (n = 11,635) was accrued over a median 13.8 y of follow-up, and 12 individual cardiovascular disease risk markers assessed at baseline.

Results: Adhering to a favorable lifestyle (4-5 healthy factors) was associated with a 25% (hazard ratio: 0.75, 95% confidence interval: 0.70, 0.81) lower hazard of CHD compared with an unfavorable lifestyle (0-1 factor), independent of PRS for high WHR. Estimated 12-y absolute risk of CHD was lower for a favorable lifestyle at high genetic risk (1.73%) and medium genetic risk (1.67%) than for an unfavorable lifestyle at low genetic risk (2.08%). Adhering to a favorable lifestyle was associated with healthier levels of cardiovascular disease risk markers (except random glucose and high-density lipoprotein), independent of PRS for high WHR.

Conclusions: Individuals who have high or medium genetic risk of abdominal obesity but adhere to a healthy lifestyle may have a lower risk of developing CHD, compared with those who have low genetic risk and an unhealthy lifestyle. Future clinical trials of lifestyle modification could be implemented for individuals at high genetic risk of abdominal obesity for the primary prevention of CHD events.

Keywords: abdominal obesity; cardiometabolic risk markers; coronary heart disease; genetic susceptibility; lifestyle.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't

MeSH terms

Cardiovascular Diseases* / complications
Coronary Disease* / genetics
Coronary Disease* / prevention & control
Genetic Predisposition to Disease
Healthy Lifestyle
Humans
Obesity / complications
Obesity, Abdominal / complications
Obesity, Abdominal / genetics
Risk Factors