Intensive glycemic control reduced coronary artery disease (CAD) events among the Action to Control Cardiovascular Disease Risk in Diabetes (ACCORD) participants with the haptoglobin (Hp) 2-2 phenotype only. It remains unknown whether Hp phenotype modifies the effect of an intensive lifestyle intervention (ILI) on CAD in type 2 diabetes. Haptoglobin phenotype was measured in 4542 samples from the Action for Health in Diabetes (Look AHEAD) study. Cox regression models assessed the effect of ILI (focused on weight loss from caloric restriction and physical activity) versus diabetes support and education (DSE) on CAD events in each phenotype group, and within pre-specified subgroups including race/ethnicity, sex, history of cardiovascular disease, diabetes medication use, and diabetes duration. 1590 (35%) participants had the Hp2-2 phenotype. The ILI did not lower glycated hemoglobin (%HbA1c) to < 6.5% in either phenotype, with a peak significant difference between treatment arms of 0.5% [non-Hp2-2] and 0.6% [Hp2-2]. The cumulative CAD incidence was 13.4% and 13.8% in the DSE arm and 12.2% and 13.6% in the ILI arm for non-Hp2-2 and Hp2-2 groups, respectively. Compared to DSE, the ILI was not associated with CAD among participants without (HR = 0.95, 95% CI 0.78–1.17) or with (0.89, 0.68–1.19) the Hp2-2 phenotype (p-interaction between Hp phenotype and ILI = 0.58). After Bonferroni correction, there were no significant results among any subgroups. Hp phenotype did not modify the effect of the weight loss ILI on risk of CAD in Look AHEAD, potentially because it did not substantially impact glycemic control among participants with or without the Hp2-2 phenotype. Further research is needed to determine if these results are conclusive.

中文翻译：

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2 型糖尿病的强化生活方式干预和常见触珠蛋白表型的冠状动脉疾病风险：Look AHEAD 研究

仅具有触珠蛋白 (Hp) 2-2 表型的糖尿病心血管疾病风险控制行动 (ACCORD) 参与者中，强化血糖控制可减少冠状动脉疾病 (CAD) 事件。目前尚不清楚 Hp 表型是否会改变强化生活方式干预 (ILI) 对 2 型糖尿病 CAD 的影响。对糖尿病健康行动 (Look AHEAD) 研究的 4542 个样本进行了触珠蛋白表型测量。Cox 回归模型评估了 ILI（重点关注热量限制和体力活动带来的体重减轻）与糖尿病支持和教育 (DSE) 对每个表型组以及预先指定的亚组（包括种族/民族、性别、病史）中 CAD 事件的影响心血管疾病、糖尿病药物使用和糖尿病持续时间。1590 名 (35%) 参与者具有 Hp2-2 表型。ILI 并未将任一表型中的糖化血红蛋白 (%HbA1c) 降低至 < 6.5%，治疗组之间的峰值显着差异为 0.5% [非 Hp2-2] 和 0.6% [Hp2-2]。对于非 Hp2-2 组和 Hp2-2 组，DSE 组的累积 CAD 发生率为 13.4% 和 13.8%，ILI 组的累积 CAD 发生率分别为 12.2% 和 13.6%。与 DSE 相比，不具有 Hp2-2 表型（HR = 0.95，95% CI 0.78–1.17）或具有（0.89，0.68–1.19）Hp2-2 表型的参与者中 ILI 与 CAD 无关（Hp 表型与 ILI 之间的 p 相互作用 = 0.58）。经过 Bonferroni 校正后，任何亚组之间均无显着结果。在 Look AHEAD 中，Hp 表型并未改变减肥 ILI 对 CAD 风险的影响，可能是因为它不会对有或没有 Hp2-2 表型的参与者的血糖控制产生实质性影响。需要进一步的研究来确定这些结果是否具有决定性。