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Lifestyle factors and genetic variants associated with cardiovascular disease in Korean patients with diabetes: a genome-wide association study
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Haejung Lee, Gaeun Park, DaeEun Lee, Min Jin Lee, Dongwon Yi
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Received April 16, 2026 Accepted July 15, 2026 Published online July 21, 2026
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DOI: https://doi.org/10.4040/jkan.26055
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 Abstract
- Purpose
This study compared the characteristics and lifestyle factors of Korean patients with diabetes according to cardiovascular disease (CVD) status, identified genetic variants associated with CVD, and examined the associations of genetic risk and lifestyle with CVD.
Methods
Data were obtained from the Health Examinees (HEXA) Study of the Korean Genome and Epidemiology Study (2004–2013). The sample included 5,337 patients with diabetes (CVD, n=499; non-CVD, n=4,838). Lifestyle factors were classified into a short-term modifiable lifestyle domain (exercise, diet, and alcohol use) and a long-term health trait domain (smoking, sleep, and body mass index). A genetic risk score (GRS) was calculated using candidate variants identified through genome-wide association analysis. Hierarchical logistic regression with simple-effects analysis was performed.
Results
The CVD group was older, had a longer duration of diabetes, and included higher proportions of men and unemployed participants than the non-CVD group. Two candidate variants showed suggestive associations with CVD (p<1×10⁻⁵). Higher GRS, higher short-term modifiable lifestyle scores, and lower long-term health trait scores were independently associated with CVD. A significant interaction was found between GRS and the short-term modifiable lifestyle domain. Higher short-term modifiable lifestyle scores were associated with increased odds of CVD among participants with GRS values of 1 and 2, but not among those with a GRS of 0.
Conclusion
Genetic risk may help identify patients with diabetes who should be prioritized for CVD prevention. The gene–lifestyle interaction highlights the need for longitudinal studies to determine optimal postdiagnosis interventions and to support targeted nursing strategies.
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