Evidence map›Paper›PMID 39939937›Full record

Trial reportBMC medicine2025

Healthy lifestyle factors and combined macrovascular and microvascular events in diabetes patients with high cardiovascular risk: results from ADVANCE.

Shoujiang You, Danni Zheng, Yanan Wang, Qiang Li, Tu N Nguyen, Ruth Peters, Xiaoying Chen, Xia Wang, Yongjun Cao, Diederick E Grobbee and 11 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Shoujiang YouDepartment of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of SooChow University, Suzhou, China.
Danni ZhengThe George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, 2000, Australia.
Yanan WangDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Qiang LiThe George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, 2000, Australia.
Tu N NguyenThe George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, 2000, Australia.
Ruth PetersThe George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, 2000, Australia.
Xiaoying ChenThe George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, 2000, Australia.
Xia WangThe George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, 2000, Australia.
Yongjun CaoDepartment of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of SooChow University, Suzhou, China.
Diederick E GrobbeeJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Stephen HarrapDepartment of Anatomy and Physiology, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia.
Giuseppe ManciaUniversity of Milano-Bicocca, Milan, Italy.
Bryan WilliamsPopulation Science & Experimental Medicine University College London, London, UK.
Neil R PoulterSchool of Public Health, Imperial College London, London, UK.
Liu LishengBeijing Hypertension League Institute, Beijing, China.
Michel MarreClinique Ambroise Paré, Neuilly-sur-Seine, France & Institut Necker-Enfants Malades, INSERM, Université Paris Cité, Paris, France.
Pavel HametMontréal Diabetes Research Centre, Centre Hospitalier de L'Université de Montréal, Quebec, Montreal, Canada.
Craig S AndersonThe George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, 2000, Australia.
Mark WoodwardThe George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, 2000, Australia.
John ChalmersThe George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, 2000, Australia.
Katie HarrisThe George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, 2000, Australia. KHarris@georgeinstitute.org.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo explore whether healthy lifestyle factors (HLFs) predict a lower risk of major macrovascular and microvascular events and death in people with type 2 diabetes (T2D) with a high risk of vascular complications.

methodsPost hoc analyses of 11,133 participants with T2D in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial who were assigned a score ranging from 0 to 4 based on the number of baseline HLFs: never smoked, moderate-to-vigorous physical activity, ideal waist/hip ratio, and low-to-moderate alcohol consumption. Multivariable Cox models were used to determine associations of 0, 1, 2, and ≥ 3 HLFs with vascular events and all-cause mortality.

resultsCompared to participants with no HLFs, hazard ratios for participants with 3 or 4 HLFs were 0.68 (95% confidence interval [CI] 0.57-0.81) for the composite of major macrovascular or microvascular events, 0.58 (0.46-0.75) for major macrovascular events, 0.78 (0.61-0.99) for microvascular events, and 0.48 (0.37-0.63) for all-cause mortality during a median follow-up of 5 years. Each increment in HLF score was significantly associated with lower rates of these outcomes. There was no heterogeneity in the effect on any outcome by HLF across randomized intensive blood glucose control and blood pressure lowering treatments.

conclusionsHLFs are associated with lower risks of major macrovascular and microvascular events and lower rates of death in high-risk adults with T2D.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Diabetic AngiopathiesHealthy LifestyleAgedExerciseFemaleHumansMaleMiddle AgedADVANCEDiabetesHealthy lifestyle factorsMajor macrovascular eventsMicrovascular events

Identifiers

PMID39939937
PMCPMC11823187

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.