| Objective: This study used lifestyle scores to explore the association of healthy lifestyle factors,their number and different combinations with metabolism and intestinal flora,and laid a foundation for the formulation of strategies and measures for early monitoring,early prevention and treatment of metabolic indicators and diseases related to metabolic abnormalities in the future.Methods: 1.Based on the UK biobank(UKB),this study explored the association between healthy lifestyle factors and metabolism.According to the recommendations of the World Cancer Research Foundation and the American Association for Cancer Research,four healthy lifestyle factors were included: moderate alcohol consumption,healthy dietary patterns,physical activity and non-smoking.The type of lifestyle was assessed by a lifestyle score,which divides lifestyle into favourable,intermediate,and unfavourable lifestyles.This study selected five metabolic syndrome indicators: central obesity,high-density lipoprotein cholesterol(HDL-C),triglyceride(TG),blood glucose and blood pressure.Based on the Logistic multiple regression model,the association between lifestyle behaviour and the risk of metabolic abnormalities was analyzed,and the OR value and its 95% confidence interval(95% CI)were calculated.Sensitivity analyses were performed using the propensity score matching method to assess the robustness of the primary results.All statistical analyses were performed using R software(version 3.5.0).2.Based on the research cohort of the Seventh Affiliated Hospital of Sun Yat-sen University,the lifestyle was divided into favourable and unfavourable lifestyles according to the lifestyle score.16s-r RNA gene sequencing was used to detect the DNA structure of the intestinal flora of the included subjects.LEfse software was used to analyze species differences between groups,compare species composition differences among samples,and detect species with significant differences in intestinal bacteria abundance among participants with different lifestyles.Dimensionality reduction was achieved by linear discriminant analysis,and the LDA(Linear Discriminant Analysis)score was used to evaluate the impact of species with significant differences.Wilcoxon rank sum test was used to compare the diversity,keystone species and abundance functional differences of gut microbiota between the two groups.The indicators of intestinal microbiota diversity were alpha diversity(including ACE index,Chao1 index,Pielou index,Shannon index,Simpon index and the number of observed species)and beta diversity.All statistical analyses were performed using R software(version 3.5.0).Results: 1.A total of 484,350 subjects were finally included,of which 45.4% were male,and 54.6% were female;The average age of the subjects was 56.5±8.1 years old.There were 49,561 people in the good lifestyle group,311,793 people in the intermediate lifestyle group and 122,996 people in the unfavourable lifestyle group.The analysis of the association between individual healthy lifestyle and metabolism found that moderate alcohol consumption,healthy diet,physical activity,and non-smoking had a good protective effect on central obesity in general,with OR values of 0.85(95% CI: 0.84,0.86),0.82(95% CI: 0.81,0.83),0.64(95% CI: 0.63,0.65)and 0.78(95% CI: 0.77,0.79)respectively;Moderate alcohol consumption,healthy diet,physical activity and non-smoking had a good protective on TG in general,the OR values were 0.87(95% CI: 0.86,0.89),0.87(95% CI: 0.86,0.88),0.76(95%CI: 0.75,0.77)and 0.79(95% CI: 0.78,0.80);Moderate drinking,healthy diet,physical activity and non-smoking had a good protective effect on HDL-C in general,with OR values of 0.75(95% CI: 0.74,0.76),0.87(95% CI: 0.86,0.88),0.72(95% CI: 0.71,0.73)and 0.90(95% CI: 0.89,0.92);Moderate drinking,healthy diet,physical activity and non-smoking had a good protective effect on blood pressure in general,and the OR values were 0.95(95% CI: 0.94,0.96),1.02(95% CI: 1.00,1.03),0.86(95% CI: 0.85,0.87),and 1.02(95% CI: 1.01,1.03);Moderate alcohol consumption,healthy diet,physical activity and non-smoking had a good protective effect on blood glucose in general in general,and the OR values were 0.82(95% CI: 0.80,0.83),0.96(95% CI:0.95,0.98),0.77(95% CI: 0.76,0.78)and 0.87(95% CI: 0.86,0.88).Compared with the population without healthy lifestyle factors,with the increase in the number of lifestyle factors,they had better protection against central obesity,HDL-C,TG,blood glucose and blood pressure.By combining the effects of multiple lifestyle factors on metabolic indicators,it was found that among people with two healthy lifestyle factors,physical activity combined with a healthy diet had the best protection against central obesity(OR = 0.52,95% CI: 0.50,0.54).Among those with three healthy lifestyle factors,the combination of physical activity,healthy diet,and non-smoking had the best protection against central obesity(OR = 0.40,95% CI: 0.38,0.41).Among the people with two healthy lifestyle factors,the combination of physical activity and non-smoking has the best protective effect on TG(OR=0.54,95% CI: 0.52,0.55).Among the people with three healthy lifestyle factors,the combination of physical activity,healthy diet and non-smoking has the best protective effect on TG(OR=0.47,95% CI: 0.45,0.48).Among those with two healthy lifestyle factors,physical activity combined with a healthy diet was the most protective for HDL-C(OR = 0.59,95% CI: 0.57,0.62).Among the population with three healthy lifestyle factors,the combination of physical activity,moderate alcohol consumption and non-smoking had the best protection for HDL-C(OR = 0.48,95% CI: 0.46,0.50).In the population with two healthy lifestyle factors,physical activity combined with non-smoking had the best protective effect on blood pressure(OR = 0.78,95% CI: 0.75,0.81),and in the population with three healthy lifestyle factors,the combination of physical activity,moderate alcohol consumption,and non-smoking had the best protective effect on blood pressure(OR = 0.72,95% CI:0.69,0.74).Among people with two healthy lifestyle factors,the protective effect of exercise combined with healthy diet had the best protective effect on blood glucose(OR= 0.57,95% CI: 0.54,0.60).Among the people with three healthy lifestyle factors,the combination of physical activity,moderate alcohol consumption and non-smoking has the best protective effect on blood glucose(OR=0.44,95% CI: 0.43,0.46).Sensitivity analysis showed that the results were robust.2.Analysis of the correlation between lifestyle and intestinal microflora.A total of196 stool samples were collected.The average age of stool providers was 44.1 ± 11.9years old.There were 91 samples of favourable lifestyles and 105 samples of unfavourable lifestyles.The analysis results showed that the species of intestinal flora in the group of favourable lifestyle were more abundant;There were statistical differences in the number of species(P=0.0043),ACE index(P=0.0064),Chao1 index(P=0.0094),Shannon index(P=0.025)and Beta diversity(P=0.05)of intestinal microorganisms observed in the favourable lifestyle group and the unfavourable lifestyle group.Among them,the bacteria groups with significant differentiation are gRuminococcus-torques-group,g-Ruminococcaceae-UCG-014,f-Fusobacteriaceae,pFusobacteria,o-Fusobacteriales,c-Fusobacteria,g-Fusobacterium,g-Paraprevotella.Furthermore,it was found that intestinal flora can affect obesity,TG,HDL-C,blood glucose and blood pressure,which indirectly proves that lifestyle can affect metabolism through literature research.Conclusion: This study shows that lifestyle can affect metabolism and intestinal flora to a certain extent.We can strengthen health education,improve compliance with a healthy lifestyle,and strengthen the awareness of health management,which has important public health significance and application value for preventing metabolic abnormalities and diseases caused. |
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