{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T07:49:52Z","timestamp":1793692192934,"version":"4.5.1"},"reference-count":44,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2020R1C1C1010890"],"award-info":[{"award-number":["NRF-2020R1C1C1010890"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2024,7,24]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Various strategies aim to better assess risks and refine prevention for patients with type 2 diabetes mellitus (T2DM), who vary in cardiovascular disease (CVD) risk. However, the prognostic value of personality and its association with lifestyle factors remain elusive.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research design and methods<\/jats:title>\n                  <jats:p>We identified 8794 patients with T2DM from the UK Biobank database between 2006 and 2010 and followed them up until the end of 2021. We assessed personality traits using the Big Five proxies derived from UK Biobank data: sociability, warmth, diligence, curiosity, and nervousness. Healthy lifestyle behaviors were determined from information about obesity, smoking status, and physical activity. The primary outcome was a composite of incident CVD, including myocardial infarction (MI), ischemic stroke (IS), atrial fibrillation (AF), and heart failure (HF).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During a median follow-up of 13.6 years, a total of 2110 patients experienced CVDs. Among personality traits, diligence was significantly associated with a reduced risk of primary and secondary outcomes. The adjusted HRs with 95% CIs were: composite CVD, 0.93 (0.89\u20130.97); MI 0.90 (0.82\u20131.00); IS 0.83 (0.74\u20130.94); AF 0.92 (0.85\u20130.98); HF 0.84 (0.76\u20130.91). Healthy lifestyle behaviors significantly reduced the risk of composite CVDs in groups with high and low diligence. The findings of a structural equation model showed that diligence directly affected the risk of the primary outcome or indirectly by modifying lifestyle behaviors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study revealed which personality traits can influence CVD risk during T2DM and how patients might benefit from adopting healthy lifestyle behaviors in relation to personality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjdrc-2024-004244","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T20:00:14Z","timestamp":1725998414000},"page":"e004244","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Association between personality, lifestyle behaviors, and cardiovascular diseases in type 2 diabetes mellitus: a population-based cohort study of UK Biobank data"],"prefix":"10.1136","volume":"12","author":[{"given":"Chan Soon","family":"Park","sequence":"first","affiliation":[{"name":"Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaewon","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Data Science Research, Seoul National University Hospital, Seoul, Republic of Korea"},{"name":"Department of Biomedical Sciences, Seoul National University Graduate School, Seoul National University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soongu","family":"Kwak","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Pyo","family":"Lee","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"},{"name":"Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung-Kwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"},{"name":"Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"},{"name":"Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Heon","family":"Kwak","sequence":"additional","affiliation":[{"name":"Division of Data Science Research, Seoul National University Hospital, Seoul, Republic of Korea"},{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University College of Medicine & Seoul National University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4053-8713","authenticated-orcid":false,"given":"Jun-Bean","family":"Park","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"},{"name":"Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"2025073112103565000_12.4.e004244.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00618-8"},{"key":"2025073112103565000_12.4.e004244.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.151"},{"key":"2025073112103565000_12.4.e004244.3","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12791"},{"key":"2025073112103565000_12.4.e004244.4","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.11.2613"},{"key":"2025073112103565000_12.4.e004244.5","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001052"},{"key":"2025073112103565000_12.4.e004244.6","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-S009"},{"key":"2025073112103565000_12.4.e004244.7","doi-asserted-by":"crossref","first-page":"S60","DOI":"10.2337\/dc22-S005","article-title":"5. 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